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- Enblad, G, et al.
(författare)
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Patients above sixty years of age with Hodgkin's lymphoma treated with a new strategy
- 2002
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 41:7-8, s. 659-667
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Tidskriftsartikel (refereegranskat)abstract
- In the Swedish National Care Programme for Hodgkin's lymphoma (HL) a less intensive chemotherapy regimen with individualized dosing (LVPP/OEPA) was introduced in 1989. In total, 139 patients, 77 between 1985 and 1988 and 62 between 1989 and 1992, were studied. Mean ages were 72 and 71 years, respectively. One hundred and nineteen patients were treated with curative intention, 63 (82%) between 1985 and 1988 vs. 56 (90%) between 1989 and 1992 (p = 0.11). All patients (13 vs. 20) treated with radiotherapy only achieved a complete remission (CR). The CR rates (67% vs. 65%) for patients treated with 6-8 cycles of chemotherapy were also similar in the two time periods. The 5-year survival rate was 45% in the period 1985-1988 and 48% in 1989-1992. The survival of elderly HL patients was thus not improved from 1985-1988 to 1989-1992. Thus efforts to improve the chemotherapy regimen with individualized dosing did not change the outcome. Many patients experienced myelosuppression and opportunistic infections that may have contributed to the poor treatment results.
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- Samuelsson, Gillis, et al.
(författare)
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Incidence of dementia related to medical, psychological and social risk factors: A longitudinal cohort study during a 25-year period
- 2003
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Ingår i: Symposium on Brain and Longevity. - 3540439587 ; , s. 117-129
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Konferensbidrag (refereegranskat)abstract
- This study is based on an entire cohort (n = 192) of 67-year-old persons born in 1902 and 1903 and living in a community in Southern Sweden. All subjects participated in interviews, psychological tests, and medical examinations. All contacts with primary health care and social services were recorded, as were death diagnoses. The cohort has been followed since 1969, with nine examinations until age 92. The incidence rate (per 1000 person years) of dementia between 67 and 92 years of age, including those alive at age 92 as well as those deceased prior to 92, was 2.8 in the first five-year period, increasing up to 44.5 between ages 87 and 92. Altogether 16 % developed dementia during the period. The mean age for diagnoses of dementia was 80 years. Fifteen presumptive social, medical and psychological risk factors for dementia have been applied (Cox regression analyses). Neither gender nor education were significant risk factors for dementia. Non-smokers tended to have a higher risk for dementia, but not a significantly higher risk. Normal blood pressure tended to increase the risk for dementia nearly significantly (p = 0.07). Diabetes increased the risk for dementia, however not significantly (p = 0.08). Using Cox regression analysis with dementia as a time-dependent covariate, it was found that dementia significantly increased the relative risk for death more than three times (CI 1.9-5.7), controlling for gender, smoking, diabetes, blood pressure, and education. Four cognitive tests were not found to be risk factors for dementia; neither were any of the medical parameters or social network variables.
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- Walsh, SH, et al.
(författare)
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Mutated V-H genes and preferential V(H)3-21 use define new subsets of mantle cell lymphoma
- 2003
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Ingår i: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 101:10, s. 4047-4054
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Tidskriftsartikel (refereegranskat)abstract
- Mantle cell lymphoma (MCL) is believed to originate from a naive B cell. However, we recently demonstrated that a subset of MCL displayed mutated V-H genes. We also reported restricted use of certain V-H genes. To assess the prognostic impact of these new findings, we performed V-H gene analysis of 110 patients, revealing that 18 (16%) patients had mutated and 92 (84%) patients had unmutated V-H genes. Because the mutation rate was low in the mutated group (2.2%-6.7%), further investigation of the germline V-H gene in T cells from 5 patients with mutated V-H genes was carried out; results showed that the unrearranged V-H gene was identical to the published sequence. These data confirm that the base pair substitutions within the rearranged V-H genes represent hyper-mutations, and indicate germinal center exposure. However, V-H gene mutation status did not correlate with prognosis because there was no difference in clinical outcome between the unmutated and mutated groups. The most frequently used V-H genes were V(H)3-21 (21 patients) and V(H)4-34 (19 patients). A novel finding was that V(H)3-21(+) MCL almost exclusively ex-pressed X light chains and displayed highly restricted use of the V(lambda)3-19 gene. V(H)3-21(+) patients had longer median survival than the remaining patients (53 vs 34 months; P = .03), but they tended to be younger at diagnosis. The combined use Of V(H)3-21/V(lambda)3-19 suggests a possible role for antigen(s) in the pathogenesis of these tumors and indicates that V(H)3-21(+) patients constitute a new MCL entity. (C) 2003 by The American Society of Hematology.
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