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Biomedical subjects

E Chiu

Publications and source records attributed to E Chiu.

117 records · Page 7Linked to original sources
PubMed1975

Hepatic morphology in Huntington's chorea.

Liver biopsy specimens from six patients with Huntington's chorea were examined locally and referred with clinical information to three colleagues abroad experienced in the interpretation of liver biopsy specimens. The minor and inconsistent abnormalities reported upon were of non-specific character. The suggested interrelation between damage to cerebral neurones and hepatocytes in Huntington's chorea was not substantiated by this study.

Histocytochemistry↗
PubMedDate not supplied

Secondary central nervous system involvement by non-Hodgkin's lymphoma: the risk factors.

The risk of secondary central nervous system (CNS) was estimated in 833 cases of non-Hodgkin's lymphoma diagnosed between January 1975 and December 1988. Fifty-one of them had CNS disease (51/833, 6.1 per cent). No case of low grade lymphoma developed CNS disease. However, 6.5 per cent and 16.7 per cent of patients with intermediate and high grade lymphomas, respectively, had secondary CNS involvement. Stage IV disease and the presence of B symptoms were also associated with an increased risk of CNS disease. Significantly higher incidence of CNS disease was seen in patients with lymphoma involving orbit (43 per cent), testis (40 per cent), peripheral blood (33 per cent), bone (29 per cent), nasal/paranasal sinuses region (23 per cent) and bone marrow (20 per cent). CNS prophylaxis is recommended to patients with an increased risk of CNS disease.

Brain Neoplasms↗
PubMedDate not supplied

Non-Hodgkin's lymphomas involving the female genital tract.

Thirteen female patients with lymphomas involving the genital tract were studied. Their median age was 50 years. There were three cases of stage I disease, one stage II and nine stage IV. The gastrointestinal tract was commonly involved in patients with disease in the ovary. The histology was mostly intermediate or high grade according to the Working Formulation. Immunophenotyping was performed in six patients and they were all B-cell tumours. There appeared to have a strong association between gastrointestinal involvement and ovarian disease. All patients received combination chemotherapy with or without additional radiotherapy and the survival of patients with stage I and II disease appeared to be superior to those with stage IV disease. However, the difference observed did not reach statistical significance because of small patient number. It remains uncertain whether lymphomas of the female genital tract by itself carries a poorer prognosis than the nodal lymphomas of comparable stage and histology.

Adult↗
PubMedDate not supplied

Primary and secondary cutaneous lymphomas in Hong Kong Chinese.

Sixty-eight Hong Kong Chinese patients with cutaneous lymphomas were studied. There were 38 males and 30 females and their median age was 52 years. According to a staging system as proposed by the Mycosis Fungoides Cooperative Group, 48 (71 per cent) of the patients had disseminated stage IV disease. There were nine (13 per cent) cases of mycosis fungoides. The remaining cases were mostly intermediate or high grade non-Hodgkin's lymphomas according to the Working Formulation. Immunophenotyping was performed in 23 cases and in 17 cases (74 per cent), T-cell tumours were identified. Many of these T-cell lymphomas were unclassifiable according to the Working Formulation and were either pleomorphic or immunoblastic-lymphadenopathy-like T-cell lymphoma according to a modified system of the Japanese Lymphoma Study Group. A variety of therapies were given to these patients and those with stage IV disease had a significantly poorer survival. On the other hand, the histology, and immunophenotype did not appear to be useful in predicting prognosis.

Adolescent↗
PubMedDate not supplied

Intensive chemotherapy for peripheral T-cell lymphomas.

Forty-two patients with previously untreated peripheral T-cell lymphomas (PTCL) were treated with an intensive chemotherapy protocol. Either the BACOP or the m-BACOD regimen was used for induction. Patients achieving complete clinical remission after three courses were given intensive consolidation and maintenance chemotherapy similar to the L10/L17M protocol designed by the Memorial Sloan-Kettering Group for acute lymphoblastic leukemia and lymphoblastic lymphoma. There were 27 (64 per cent) males and 15 (36 per cent) females. The median age was 54 years (mean 53, range 15 to 68). Seven of them (17 per cent) had stage I disease, four (10 per cent) stage II, seven (17 per cent) stage III and 24 (57 per cent) stage IV. Eighteen patients (43 per cent) had B symptoms and four (10 per cent) had bulky disease. According to the Working Formulation, the histology was diffuse mixed in 16 patients (38 per cent), diffuse large cell in 18 (43 per cent), diffuse immunoblastic in four (10 per cent) and unclassifiable in four (10 per cent). According to a modified Japanese Lymphoma Study Group's classification, the histology in 24 patients (57 per cent) was the pleomorphic type, in 13 (31 per cent) immunoblastic-lymphadenopathy-like (IBL-like), and in five (12 per cent) unclassifiable. The overall complete remission rate was 67 per cent. Twenty-five per cent of the complete responders relapsed and the DFS of the CR patients was 62 per cent at three years. The overall survival of all patients at three years was 52 per cent. Patients with stage I, II and III disease had significantly better CR rate (100 per cent versus 42 per cent, p = 0.001) and overall survival (82 per cent versus 35 per cent at three years, p = 0.01) than those with stage IV disease but the relapse rate and DFS of CR patients were similar. This study shows that the prognosis of patients with PTCL can be improved by intensive therapy.

Adolescent↗
PubMedDate not supplied

COPP chemotherapy for elderly patients with intermediate and high grade non-Hodgkin's lymphoma.

One hundred and forty-one consecutive patients above and 231 below the age of 60 years with previously untreated intermediate or high grade non-Hodgkin's lymphoma were included in this study. Patients above the age of 60 years were treated with the COPP chemotherapy regimen. The younger patients, at or below the age of 60, received a doxorubicin-containing regimen (119 had CHOP, 65 had BACOP and 47 had m-BACOD). For stage I patients, the clinical results were similar but for stage II, III or IV disease, those receiving COPP had significantly worse CR rate and survival than those who had a doxorubicin-containing regimen. Multivariate analysis on patients receiving the COPP chemotherapy revealed that the independent prognostic variables significantly determining CR rate and survival included clinical stage (p = 0.04) and serum lactate dehydrogenase level (p = 0.001). Myelosuppression was the major toxicity following COPP chemotherapy in this group of patients. There were 10 (7 per cent) treatment-related deaths. Compared to the reported results using doxorubicin-containing regimens to treat elderly patients with aggressive NHL in the literature, the more aggressive treatment does not appear to improve significantly the clinical outcome of this group of patients and seems to produce treatment results very much similar to COPP. However, accurate comparison is difficult because of the variation in the patient characteristics. Further prospective controlled randomized trials will be necessary to determine the optimal therapy for these patients.

Adolescent↗
PubMedDate not supplied

Prognostic factors for primary gastrointestinal lymphoma.

The gastrointestinal tract is a common primary extranodal site for non-Hodgkin's lymphoma. There is however no uniform consensus on its pathological classification, clinical staging system and management. This paper reports the experience in the management of 425 Chinese patients with primary gastrointestinal lymphoma in Hong Kong from January 1975 to June 1993. There were 230 (54 per cent) males and 195 (46 per cent) females. Their median age was 53 years. The primary sites were: the esophagus in three (1 per cent), stomach in 238 (56 per cent), small intestine in 131 (31 per cent) and large intestine in 53 (12 per cent). According to the Working Formulation, there were 20 (4.7 per cent) small lymphocytic, 10 (2.4 per cent) follicular small cleaved cell, 15 (3.5 per cent) follicular mixed, five (1.2 per cent) follicular large cell, 40 (9.4 per cent) diffuse small cleaved cell, 50 (12 per cent) diffuse mixed, 181 (43 per cent) diffuse large cell, 30 (7.1 per cent) immunoblastic, five (1.2 per cent) lymphoblastic, 10 (2.4 per cent) diffuse small non-cleaved cell and 50 (14 per cent) unclassifiable lymphoma. Immunophenotyping was performed in 199 (47 per cent) patients: 90 per cent B-cell, 7 per cent T-cell and 3 per cent uncertain. According to a Manchester system, 81 (19 per cent) patients had stage I disease, 44 (10 per cent) stage II, 85 (20 per cent) stage III and 215 (51 per cent) stage IV. B symptoms were present in 275 (65 per cent) patients and bulky disease in 104 (25 per cent). Surgery followed by chemotherapy was the mainstay of treatment. Of the 408 patients treated, 63 per cent had a complete remission with relapse rate of 42 per cent. For those with complete remission, 47 per cent were free from disease at 5 years. The overall median survival of all patients was 45 per cent at 5 years. Multivariate analysis revealed that significant independent prognostic factors predicting better survival were young age of < 60 years, low grade histology, stage I and II disease and absence of bulky tumour. For gastric lymphoma, aggressive surgery did not significantly improve their outcome. Chemotherapy appears to play an important role in the management of gastrointestinal lymphoma. Better classification of the primary gastrointestinal lymphoma and more refined stratification of the patients according to the prognostic variables may allow individualization of treatment. Prospective randomized studies are essential to define the relative roles of surgery, chemotherapy and radiotherapy.

Adult↗