Abstract：
OBJECTIVES:To determine the long-term outcome of patients presenting with synchronous lymphoma and severe liver dysfunction and to describe the outcome of patients treated with initial mechlorethamine-based therapy used as a bridge to more conventional chemotherapy. PATIENTS AND METHODS:We reviewed the clinical course of all patients diagnosed as having lymphoma who presented with severe liver dysfunction and received intravenous mechlorethamine between September 1988 and February 2003 at the Mayo Clinic in Rochester, Minn. RESULTS:Forty-one patients were identified, 33 (80%) of whom had newly diagnosed, previously untreated lymphoma. Thirty-seven (90%) had non-Hodgkin lymphoma, and 4 (10%) had Hodgkin disease. Thirty-four patients (83%) had stage IV disease, and 31 (84%) of 37 had an intermediate-high International Prognostic Index. The median total bilirubin level before therapy was 10.7 mg/dL (range, 2.5-30.2 mg/dL), and the median alkaline phosphatase level was 982 U/L (range, 233-3415 U/L). In addition to mechlorethamine, 34 patients (83%) received concomitant corticosteroids, and 12 (29%) received concomitant rituximab. Twenty-two patients (54%) had sufficient improvement in liver function to receive subsequent standard chemotherapy. Nine patients (22%) are alive and disease-free at a median of 31 months (range, 4 to > or = 87 months) after mechlorethamine treatment. Factors associated with improved overall survival included improvement in bilirubin levels (P < .001) and receiving subsequent standard chemotherapy (P = .001). CONCLUSION:Mechlorethamine, high-dose corticosteroids, and rituximab are useful therapeutic interventions for this unique group of patients with lymphoma and severe liver dysfunction. Substantial clinical improvement and long-term survival are possible.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Ghobrial IM,Wolf RC,Pereira DL,Fonseca R,White WL,Colgan JP,Habermann TM,Inwards DJ,Markovic SN,Ansell SM,Micallef IN,Porrata LF,Witzig TEdoi
10.4065/79.2.169keywords:
subject
Has Abstractpub_date
2004-02-01 00:00:00pages
169-75issue
2eissn
0025-6196issn
1942-5546pii
S0025-6196(11)63164-9journal_volume
79pub_type
杂志文章abstract：:B-cell chronic lymphocytic leukemia (B-CLL) is a relatively indolent hematologic malignant disease that, despite a good response to nonaggressive orally administered chemotherapy, currently remains incurable. The overall median duration of survival is more than 5 years, and the presence of anemia or thrombocytopenia a...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)61551-1
更新日期：1992-04-01 00:00:00
abstract：:Radionuclide angiography was used to study the effects of supine and upright bicycle exercise and handgrip exercise in 17 (12 well-trained) normal subjects before (control) and immediately after the administration of propranolol (160 mg/day for 4 days). Cardiac hemodynamic values were related to position in that contr...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)62411-2
更新日期：1984-09-01 00:00:00
abstract：BACKGROUND:The efficacy of fine-needle aspiration (FNA) biopsy and its role in the management of a nodular goiter are clearly established. The accuracy of cytologic diagnosis approaches 95%. FINDINGS:FNA biopsy is a reasonable approach to thyroid nodules; it has decreased costs substantially because it facilitates sel...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)61611-5
更新日期：1994-01-01 00:00:00
abstract：:In this case of Sertoli cell tumor of the testis, no laboratory or clinical evidence of hormonal imbalance was present. The histologic and ultrastructure characteristic of the tumor agreed closely with previous reports on these rare tumors of the gonadal stroma. ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1975-08-01 00:00:00
abstract：:Treatment responses to imatinib vary among patients with chronic myeloid leukemia (CML), and definitions of treatment failure and suboptimal response have been published. This article discusses monitoring and treatment of patients with CML after failure of or suboptimal response to imatinib therapy. We reviewed articl...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/S0025-6196(11)60824-0
更新日期：2009-02-01 00:00:00
abstract：:Noninvasive ventilation refers to the delivery of assisted ventilatory support without the use of an endotracheal tube. Noninvasive positive pressure ventilation (NPPV) can be delivered by using a volume-controlled ventilator, a pressure-controlled ventilator, a bilevel positive airway pressure ventilator, or a contin...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/74.8.817
更新日期：1999-08-01 00:00:00
abstract：:Of 53 patients with horseshoe kidney (9 in the present series), 45 underwent operation for an abdominal aortic aneurysm: 40 electively and 5 on an emergency basis. The remaining eight patients underwent revascularization for arteriosclerosis obliterans. Of the 53 patients, 35 (66%) had renal artery anomalies. The anom...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1979-02-01 00:00:00
abstract：:For primary care physicians, obesity is one of the most challenging problems confronted in office practice. The disorder is Increasing in prevalence despite the efforts of both patients and physicians. Treatment requires a multimodality approach that addresses diet, physical activity, and behavioral issues. Medication...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/82.1.93
更新日期：2007-01-01 00:00:00
abstract：OBJECTIVE:To determine whether blood type affects the risk of thromboembolic complications in patients with atrial fibrillation (AF). PATIENTS AND METHODS:The Mayo Clinic electronic medical record was searched (between January 1, 2004, and December 31, 2010) to identify all patients with AF with blood group assessment...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2014.11.013
更新日期：2015-02-01 00:00:00
abstract：:Severe hypocalcemia may require prompt intervention to avoid life-threatening consequences. We report a case in which a 78-year-old man had a critically low serum calcium level measured with use of standard colorimetric assay after gadodiamide administration during magnetic resonance angiography. Reanalysis of the sam...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/80.12.1655
更新日期：2005-12-01 00:00:00
abstract：:We reviewed the epidemiologic characteristics, diagnosis, clinical features, and management of cytomegalovirus (CMV) infection after renal transplantation. CMV, the major viral pathogen after renal transplantation, increases patient morbidity and mortality. The spectrum of CMV infection ranges from latent infection to...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)60828-3
更新日期：1992-09-01 00:00:00
abstract：:The first 100 liver transplantations at the Mayo Clinic were performed in 83 patients, who required a total of 917 patient days in the intensive-care unit (ICU). The mean duration of stay in the ICU was 5.91 days after liver transplantation and 6.15 days for patients who subsequently required readmission to the ICU. D...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65734-6
更新日期：1989-04-01 00:00:00
abstract：:The clinical impact of the association between oral contraceptive (OC) use and breast cancer risk is important given that OCs are the most commonly prescribed contraceptive agent and that more than a quarter of a million women are diagnosed as having breast cancer in the United States annually. Substantial changes to ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/83.1.86
更新日期：2008-01-01 00:00:00
abstract：:Among 169 adult pathologically staged patients with Hodgkin's disease who were treated at the Mayo Clinic between 1974 and 1978, we identified four cases of second malignant lesions that developed. The median duration of follow-up after diagnosis for the entire population was 4.1 years. Of the 169 patients, 73 receive...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60440-6
更新日期：1984-07-01 00:00:00
abstract：OBJECTIVE:To examine the association between specific adipose tissue depots and the risk of incident cancer in the Dallas Heart Study. PATIENTS AND METHODS:Individuals without prevalent cancer in the Dallas Heart Study underwent quantification of adipose depots: visceral adipose tissue (VAT), abdominal subcutaneous ad...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2016.12.023
更新日期：2017-04-01 00:00:00
abstract：:Although measurements of trunk flexibility are an important part of a clinical examination, subjective methods are usually used to assess spinal mobility. We studied three easily performed objective techniques for determining trunk flexibility (the common "fingertip-to-floor" test, the modified Schober and Moll tests,...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61848-5
更新日期：1986-03-01 00:00:00
abstract：:Staphylococcus lugdunensis, a coagulase-negative staphylococcus, is being increasingly recognized as the cause of serious infections. We report 2 cases of total knee arthroplasty infection caused by S lugdunensis. S lugdunensis frequently produces a clumping factor that can result in a positive slide (short) coagulase...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/75.5.511
更新日期：2000-05-01 00:00:00
abstract：OBJECTIVE:To assess long-term secular trends in the utilization of bilateral compared with unilateral orchiectomy in the community. PATIENTS AND METHODS:This population-based descriptive study reviewed medical records of all Olmsted County, Minnesota, men undergoing orchiectomy between 1956 and 2000. RESULTS:Over the...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/76.12.1199
更新日期：2001-12-01 00:00:00
abstract：OBJECTIVE:To review the association of coronary artery calcification with coronary atherosclerosis and its potential clinical application as detected on electron beam computed tomography (EBCT). DESIGN:A literature review of coronary artery calcification, coronary artery disease, and EBCT is presented, and clinical ap...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/71.4.369
更新日期：1996-04-01 00:00:00
abstract：:Many patients taking customary doses of levothyroxine have slightly elevated serum thyroxine (T4), apparently normal serum triiodothyronine, suppressed serum thyrotropin (thyroid-stimulating hormone; TSH) concentrations, and no clinical symptoms of hyperthyroidism. Recent reports suggest that these patients may have a...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)65409-3
更新日期：1988-12-01 00:00:00
abstract：:Seven cases of bacteremia following transrectal needle biopsy of the prostate were reviewed. Symptoms developed within 24 to 72 hours after the procedure and required hospitalization and treatment with parenteral antibiotics. Escherichia coli was the causative agent in five patients and Klebsiella pneumoniae in two. A...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1980-08-01 00:00:00
abstract：:Studies were undertaken to determine the effects of lidocaine on ischemic myocardium, which was induced by coronary artery constriction in open-chested dogs. A real-time epicardial fluorescent technique to detect in vivo-reduced nicotinamide adenine dinucleotide (NADH) during 60 seconds of ischemia was used. Blood flo...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1982-07-01 00:00:00
abstract：:Nasal telangiectasias, a common condition, can be caused by chronic exposure to ultraviolet light, rosacea, topically applied corticosteroids, or rhinoplasty. Use of the argon laser for 15 to 45 minutes in a continuous mode over the entire involved area can produce considerable lightening of the nasal redness and impr...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)62611-1
更新日期：1986-11-01 00:00:00
abstract：:The penicillin family of antibiotics remains an important part of our antimicrobial armamentarium. In general, these agents have bactericidal activity, excellent distribution throughout the body, low toxicity, and efficacy against infections caused by susceptible bacteria. The initial introduction of aqueous penicilli...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/74.3.290
更新日期：1999-03-01 00:00:00
abstract：OBJECTIVE:To evaluate the efficacy and tolerability of sumatriptan, 50-mg and 100-mg tablets, compared with placebo for treatment of migraine at the first sign of pain. PATIENTS AND METHODS:Two identical multicenter randomized, double-blind, placebo-controlled, single-attack studies were conducted from May through Nov...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.4065/78.10.1214
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVE:To evaluate the association between coffee consumption and mortality from all causes and from cardiovascular disease. PATIENTS AND METHODS:Data from the Aerobics Center Longitudinal Study representing 43,727 participants with 699,632 person-years of follow-up were included. Baseline data were collected by an...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.06.020
更新日期：2013-10-01 00:00:00
abstract：OBJECTIVE:To determine the risk of congenital cardiac abnormalities associated with use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy. PATIENTS AND METHODS:We conducted a retrospective review of the medical records of all pregnant women presenting at Mayo Clinic's site in Rochester, MN, from Janu...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/84.1.23
更新日期：2009-01-01 00:00:00
abstract：OBJECTIVE:To assess early and late outcomes, including bleeding, in patients with thrombocytopenia undergoing percutaneous coronary intervention (PCI). PATIENTS AND METHODS:We performed a retrospective single-center study of patients with preprocedural thrombocytopenia (platelet count ≤100,000/μL; n=204) undergoing PC...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2016.05.008
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:To investigate the impact of obesity and underweight on adverse in-hospital outcomes in pulmonary embolism (PE). PATIENTS AND METHODS:Patients diagnosed as having PE based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification code I26 in the G...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2019.04.035
更新日期：2019-10-01 00:00:00
abstract：:Eleven patients with Alport's syndrome had renal transplantation between 1963 and 1980. The mean follow-up is 6 years (6 months to 14 years). All 11 patients are currently alive. Ten have functioning grafts, and in nine the serum creatinine concentration is less than 2 mg/dl. Three patients received a second allograft...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
