Bio

Clinical Focus


  • Cancer > Lymphoma
  • Hodgkin's Disease
  • Hodgkin's Disease - Hematology
  • Hodgkin's Disease - Medical Oncology
  • Lymphoma
  • Medical Oncology

Academic Appointments


Professional Education


  • Fellowship:Memorial Sloan-Kettering Cancer Center (1958) NY
  • Medical Education:Case Western Reserve University School of Dentistry (1953) OH
  • Residency:Peter Bent Brigham Hospital (1961) MA
  • Residency:Peter Bent Brigham Hospital (1957) MA
  • Board Certification: Medical Oncology, American Board of Internal Medicine (1973)
  • Board Certification: Internal Medicine, American Board of Internal Medicine (1961)
  • Internship:University Hospitals of Cleveland (1954) OH

Research & Scholarship

Current Research and Scholarly Interests


Clinical Investigations of Hodgkin’s Disease: Current trials are defining (1) the utility of an abbreviated chemotherapy and minimal radiotherapy for favorable, clinically-staged patients with the disease; (2) the development of new dose-intensive chemotherapy programs for unfavorable and advanced disease. In collaboration with radiotherapists and Dr. Sandra Horning, careful retrospective and prospective studies of fertility, cardiopulmonary and secondary neoplasms are being done.

Clinico-laboratory Studies in the Non-Hodgkin’s Lymphomas: A major research interest of Dr. Rosenberg is the clinical, pathological and molecular basis of diagnosis, evolution, treatment and understanding of the non-Hodgkin’s lymphomas. This research is performed by a large interdisciplinary group of investigators which Dr. Ronald Levy directs.

Teaching

2014-15 Courses


Publications

All Publications


  • The Paris Conference "La Radiothérapie de la Maladie de Hodgkin": A First Step in the Cure of Hodgkin Disease. International journal of radiation oncology, biology, physics Hoppe, R. T., Rosenberg, S. A. 2015; 92 (1): 3-4

    View details for DOI 10.1016/j.ijrobp.2015.01.027

    View details for PubMedID 25863747

  • Melanoma NOS1 expression promotes dysfunctional IFN signaling JOURNAL OF CLINICAL INVESTIGATION Liu, Q., Tomei, S., Ascierto, M. L., De Giorgi, V., Bedognetti, D., Dai, C., Uccellini, L., Spivey, T., Pos, Z., Thomas, J., Reinboth, J., Murtas, D., Zhang, Q., Chouchane, L., Weiss, G. R., Slingluff, C. L., Lee, P. P., Rosenberg, S. A., Alter, H., Yao, K., Wang, E., Marincola, F. M. 2014; 124 (5): 2147-2159

    Abstract

    In multiple forms of cancer, constitutive activation of type I IFN signaling is a critical consequence of immune surveillance against cancer; however, PBMCs isolated from cancer patients exhibit depressed STAT1 phosphorylation in response to IFN-α, suggesting IFN signaling dysfunction. Here, we demonstrated in a coculture system that melanoma cells differentially impairs the IFN-α response in PBMCs and that the inhibitory potential of a particular melanoma cell correlates with NOS1 expression. Comparison of gene transcription and array comparative genomic hybridization (aCGH) between melanoma cells from different patients indicated that suppression of IFN-α signaling correlates with an amplification of the NOS1 locus within segment 12q22-24. Evaluation of NOS1 levels in melanomas and IFN responsiveness of purified PBMCs from patients indicated a negative correlation between NOS1 expression in melanomas and the responsiveness of PBMCs to IFN-α. Furthermore, in an explorative study, NOS1 expression in melanoma metastases was negatively associated with patient response to adoptive T cell therapy. This study provides a link between cancer cell phenotype and IFN signal dysfunction in circulating immune cells.

    View details for DOI 10.1172/JCI69611

    View details for Web of Science ID 000335424500029

    View details for PubMedID 24691438

  • Histologic subtypes of breast cancer following radiotherapy for Hodgkin lymphoma ANNALS OF ONCOLOGY Horst, K. C., Hancock, S. L., OGNIBENE, G., Chen, C., Advani, R. H., Rosenberg, S. A., Donaldson, S. S., Hoppe, R. T. 2014; 25 (4): 848-851

    Abstract

    The purpose of the study was to determine whether breast cancers (BCs) that develop in women previously irradiated for Hodgkin lymphoma (HL) are biologically similar to sporadic BC.We retrospectively reviewed the charts of patients who developed BC after radiotherapy (RT) for HL. Tumors were classified as ductal carcinoma in situ (DCIS) or invasive carcinoma. Invasive carcinomas were further characterized according to the subtype: hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. BCs after HL were compared with four age-matched sporadic, non-breast cancer (BRCA) I or II mutated BCs.One hundred forty-seven HL patients who were treated with RT between 1966 and 1999 and subsequently developed BCs were identified. Of these, 65 patients with 71 BCs had complete pathologic information. The median age at HL diagnosis was 23 (range, 10-48). The median age at BC diagnosis was 44 (range, 28-66). The median time to developing BC was 20 years. Twenty cancers (28%) were DCIS and 51 (72%) were invasive. Of the 51 invasive cancers, 24 (47%) were HR+/HER2-, 2 (4%) were HR+/HER2+, 5 (10%) were HR-/HER2+, and 20 (39%) were HR-/HER2-. There were no differences in BC histologic subtype according to the age at which patients were exposed to RT, the use of chemotherapy for HL treatment, or the time from RT exposure to the development of BC. In a 4 : 1 age-matched comparison to sporadic BCs, BCs after HL were more likely to be HR-/HER2- (39% versus 14%) and less likely to be HR+/HER2- (47% versus 61%) or HR+/HER2+ (4% versus 14%) (P = 0.0003).BCs arising in previously irradiated breast tissue were more likely to be triple negative compared with age-matched sporadic invasive cancers and less likely to be HR positive. Further studies will be important to determine the molecular pathways of carcinogenesis in breast tissue that is exposed to RT.

    View details for DOI 10.1093/annonc/mdu017

    View details for Web of Science ID 000334077000014

    View details for PubMedID 24608191

  • Improvements in observed and relative survival in follicular grade 1-2 lymphoma during 4 decades: the Stanford University experience BLOOD Tan, D., Horning, S. J., Hoppe, R. T., Levy, R., Rosenberg, S. A., Sigal, B. M., Warnke, R. A., Natkunam, Y., Han, S. S., Yuen, A., Plevritis, S. K., Advani, R. H. 2013; 122 (6): 981-987

    Abstract

    Recent studies report an improvement in overall survival (OS) of patients with follicular lymphoma (FL). Previously untreated patients with grade 1-2 FL referred from 1960-2003 and treated at Stanford were identified. Four eras were considered: era 1, pre-anthracycline (1960-1975, n=180); era 2, anthracycline (1976-1986, n=426), era 3, aggressive chemotherapy/purine analogs (1987-1996, n=471) and era 4, rituximab (1997-2003, n=257). Clinical characteristics, patterns of care and survival outcomes were assessed. Observed OS was compared with the expected OS calculated from Berkeley Mortality Database life tables derived from population matched by gender and age at time of diagnosis. The median OS was 13.6 years. Age, gender and stage did not differ across the eras. Although primary treatment varied, event free survival after the first treatment did not differ between eras (p=0.17). Median OS improved from approximately 11 years in eras 1 and 2 to 18.4 years in era 3 and has not yet been reached for era 4 (p<0.001) with no suggestion of a plateau in any era. These improvements in OS exceeded improvements in survival in the general population during the same time period. Several factors, including better supportive care and effective therapies for relapsed disease, are likely responsible for this improvement.

    View details for DOI 10.1182/blood-2013-03-491514

    View details for Web of Science ID 000322879100021

    View details for PubMedID 23777769

  • Efficacy of abbreviated Stanford V chemotherapy and involved-field radiotherapy in early-stage Hodgkin lymphoma: mature results of the G4 trial ANNALS OF ONCOLOGY Advani, R. H., Hoppe, R. T., Baer, D., Mason, J., Warnke, R., Allen, J., Daadi, S., Rosenberg, S. A., Horning, S. J. 2013; 24 (4): 1044-1048

    Abstract

    To assess the efficacy of an abbreviated Stanford V regimen in patients with early-stage Hodgkin lymphoma (HL). PATIENTS AND METHODS PATIENTS: with untreated nonbulky stage I-IIA supradiaphragmatic HL were eligible for the G4 study. Stanford V chemotherapy was administered for 8 weeks followed by radiation therapy (RT) 30 Gy to involved fields (IF). Freedom from progression (FFP), disease-specific survival (DSS) and overall survival (OS) were estimated.All 87 enrolled patients completed the abbreviated regimen. At a median follow-up of 10 years, FFP, DSS and OS are 94%, 99% and 94%, respectively. Therapy was well tolerated with no treatment-related deaths.Mature results of the abbreviated Stanford V regimen in nonbulky early-stage HL are excellent and comparable to the results from other contemporary therapies.

    View details for DOI 10.1093/annonc/mds542

    View details for Web of Science ID 000316701300027

    View details for PubMedID 23136225

  • Risk of Therapy-Related Secondary Leukemia in Hodgkin Lymphoma: The Stanford University Experience Over Three Generations of Clinical Trials JOURNAL OF CLINICAL ONCOLOGY Koontz, M. Z., Horning, S. J., Balise, R., Greenberg, P. L., Rosenberg, S. A., Hoppe, R. T., Advani, R. H. 2013; 31 (5): 592-598

    Abstract

    To assess therapy-related acute myeloid leukemia/myelodysplastic syndrome (t-AML/MDS) risk in patients treated for Hodgkin lymphoma (HL) on successive generations of Stanford clinical trials.Patients with HL treated at Stanford with at least 5 years of follow-up after completing therapy were identified from our database. Records were reviewed for outcome and development of t-AML/MDS.Seven hundred fifty-four patients treated from 1974 to 2003 were identified. Therapy varied across studies. Radiotherapy evolved from extended fields (S and C studies) to involved fields (G studies). Primary chemotherapy was mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) or procarbazine, mechlorethamine, and vinblastine (PAVe) in S studies; MOPP, PAVe, vinblastine, bleomycin, and methotrexate (VBM), or doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in C studies; and VbM (reduced dose of bleomycin compared with VBM) or mechlorethamine, doxorubicin, vinblastine, vincristine, bleomycin, etoposide, and prednisone (Stanford V) in G studies. Cumulative exposure to alkylating agent (AA) was notably lower in the G studies compared with the S and C studies, with a 75% to 83% lower dose of nitrogen mustard in addition to omission of procarbazine and melphalan. Twenty-four (3.2%) of 754 patients developed t-AML/MDS, 15 after primary chemotherapy and nine after salvage chemotherapy for relapsed HL. The incidence of t-AML/MDS was significantly lower in the G studies (0.3%) compared with the S (5.7%) or C (5.2%) studies (P < .001). Additionally, in the G studies, no t-AML/MDS was noted after primary therapy, and the only patient who developed t-AML/MDS did so after second-line therapy.Our data demonstrate the relationship between the cumulative AA dose and t-AML/MDS. Limiting the dose of AA and decreased need for secondary treatments have significantly reduced the incidence of t-AML/MDS, which was extremely rare in the G studies (Stanford V era).

    View details for DOI 10.1200/JCO.2012.44.5791

    View details for Web of Science ID 000314820400017

    View details for PubMedID 23295809

  • Two Hundred Years of Cancer Research NEW ENGLAND JOURNAL OF MEDICINE DeVita, V. T., Rosenberg, S. A. 2012; 366 (23): 2207-2214

    View details for DOI 10.1056/NEJMra1204479

    View details for Web of Science ID 000304863400010

    View details for PubMedID 22646510

  • Whole Blood Gene Expression Testing for Coronary Artery Disease in Nondiabetic Patients: Major Adverse Cardiovascular Events and Interventions in the PREDICT Trial JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH Rosenberg, S., Elashoff, M. R., Lieu, H. D., Brown, B. O., Kraus, W. E., Schwartz, R. S., Voros, S., Ellis, S. G., Waksman, R., McPherson, J. A., Lansky, A. J., Topol, E. J. 2012; 5 (3): 366-374

    Abstract

    The majority of first-time angiography patients are without obstructive coronary artery disease (CAD). A blood gene expression score (GES) for obstructive CAD likelihood was validated in the PREDICT study, but its relation to major adverse cardiovascular events (MACE) and revascularization was not assessed. Patients (N = 1,160) were followed up for MACE and revascularization 1 year post-index angiography and GES, with 1,116 completing follow-up. The 30-day event rate was 23% and a further 2.2% at 12 months. The GES was associated with MACE/revascularizations (p < 0.001) and added to clinical risk scores. Patients with GES >15 trended towards increased >30 days MACE/revascularization likelihood (odds ratio = 2.59, 95% confidence interval = 0.89-9.14, p = 0.082). MACE incidence overall was 1.5% (17 of 1,116) and 3 of 17 patients had GES ≤ 15. For the total low GES group (N = 396), negative predictive value was 90% for MACE/revascularization and >99% for MACE alone, identifying a group of patients without obstructive CAD and highly unlikely to suffer MACE within 12 months.

    View details for DOI 10.1007/s12265-012-9353-z

    View details for Web of Science ID 000304111300016

    View details for PubMedID 22396313

  • STAGE I-IIIA NON-BULKY HODGKIN'S LYMPHOMA. IS FURTHER DISTINCTION BASED ON PROGNOSTIC FACTORS USEFUL? THE STANFORD EXPERIENCE INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS Advani, R. H., Hoppe, R. T., Maeda, L. S., Baer, D. M., Mason, J., Rosenberg, S. A., Horning, S. J. 2011; 81 (5): 1374-1379

    Abstract

    In the United States, early-stage Hodgkin's lymphoma (HL) is defined as asymptomatic stage I/II non-bulky disease. European groups stratify patients to more intense treatment by considering additional unfavorable factors, such as age, number of nodal sites, sedimentation rate, extranodal disease, and elements of the international prognostic score for advanced HL. We sought to determine the prognostic significance of these factors in patients with early-stage disease treated at Stanford University Medical Center.This study was a retrospective analysis of 101 patients treated with abbreviated Stanford V chemotherapy (8 weeks) and 30-Gy (n=84 patients) or 20-Gy (n=17 patients) radiotherapy to involved sites. Outcomes were assessed after applying European risk factors.At a median follow-up of 8.5 years, freedom from progression (FFP) and overall survival (OS) rates were 94% and 97%, respectively. From 33% to 60% of our patients were unfavorable per European criteria (i.e., German Hodgkin Study Group [GHSG], n=55%; European Organization for Research and Treatment of Cancer, n=33%; and Groupe d'Etudes des Lymphomes de l'Adulte, n=61%). Differences in FFP rates between favorable and unfavorable patients were significant only for GHSG criteria (p=0.02) with there were no differences in OS rates for any criteria. Five of 6 patients who relapsed were successfully salvaged.The majority of our patients deemed unfavorable had an excellent outcome despite undergoing a significantly abbreviated regimen. Application of factors used by the GHSG defined a less favorable subset for FFP but with no impact on OS. As therapy for early-stage disease moves to further reductions in therapy, these factors take on added importance in the interpretation of current trial results and design of future studies.

    View details for DOI 10.1016/j.ijrobp.2010.07.041

    View details for Web of Science ID 000297602400024

    View details for PubMedID 20934280

  • Classical Hodgkin Lymphoma in First Complete Remission: Is There a Role for F-18 FDG PET/CT Surveillance? Lagaru, A., Maeda, L. S., Lin, F. I., Hoppe, R. T., Rosenberg, S. A., Gambhir, S. S., Advani, R. H. SPRINGER. 2010: S212-S213
  • Rare presentation of classical Hodgkin lymphoma with a clonal T-cell receptor gene rearrangement in the tissue LEUKEMIA & LYMPHOMA Nguyen, T. T., Warnke, R. A., Seo, K., Rosenberg, S. A., Arber, D. A. 2010; 51 (7): 1356-1359

    View details for DOI 10.3109/10428194.2010.486094

    View details for Web of Science ID 000279485700026

    View details for PubMedID 20496992

  • Mid-treatment Metabolic Tumor Volume Predicts Progression and Death among Patients with Hodgkin's Disease Tseng, D., Rachakonda, L. P., Su, Z., Advani, R., Horning, S., Rosenberg, S. A., Hoppe, R. T., Quon, A., Graves, E. E., Loo, B. W., Tran, P. T. ELSEVIER SCIENCE INC. 2010: S546-S547
  • An SOS-Regulated Type 2 Toxin-Antitoxin System JOURNAL OF BACTERIOLOGY Singletary, L. A., Gibson, J. L., Tanner, E. J., McKenzie, G. J., Lee, P. L., Gonzalez, C., Rosenberg, S. M. 2009; 191 (24): 7456-7465

    Abstract

    The Escherichia coli chromosome encodes seven demonstrated type 2 toxin-antitoxin (TA) systems: cassettes of two or three cotranscribed genes, one encoding a stable toxin protein that can cause cell stasis or death, another encoding a labile antitoxin protein, and sometimes a third regulatory protein. We demonstrate that the yafNO genes constitute an additional chromosomal type 2 TA system that is upregulated during the SOS DNA damage response. The yafNOP genes are part of the dinB operon, of which dinB underlies stress-induced mutagenesis mechanisms. yafN was identified as a putative antitoxin by homology to known antitoxins, implicating yafO (and/or yafP) as a putative toxin. Using phage-mediated cotransduction assays for linkage disruption, we show first that yafN is an essential gene and second that it is essential only when yafO is present. Third, yafP is not a necessary part of either the toxin or the antitoxin. Fourth, although DinB is required, the yafNOP genes are not required for stress-induced mutagenesis in the Escherichia coli Lac assay. These results imply that yafN encodes an antitoxin that protects cells against a yafO-encoded toxin and show a protein-based TA system upregulated by the SOS response.

    View details for DOI 10.1128/JB.00963-09

    View details for Web of Science ID 000272030400009

    View details for PubMedID 19837801

  • Efficacy of Abbreviated Stanford V Chemotherapy and Involved Field Radiotherapy in Early Stage Hodgkin's Disease: Mature Results of the G4 Trial. Advani, R. H., Hoppe, R. T., Baer, D. M., Mason, J., Rosenberg, S. A., Horning, S. J. AMER SOC HEMATOLOGY. 2009: 666-667
  • Role or FDG-PET/CT Surveillance for Patients with Classical Hodgkin's Disease in First Complete Response: The Stanford University Experience. Maeda, L. S., Horning, S. J., Iagaru, A. H., Lin, F. I., Hoppe, R. T., Rosenberg, S. A., Advani, R. H. AMER SOC HEMATOLOGY. 2009: 626-626
  • Dynamic CD8 T-cell responses to tumor-associated Epstein-Barr virus (EBV) antigens in patients with EBV-negative Hodgkin's disease Kohrt, H. E., Advani, R., Hoppe, R., Rosenberg, S., Horning, S., Lee, P. P. AMER SOC CLINICAL ONCOLOGY. 2009
  • Dynamic CD8 T-Cell Responses to Tumor-Associated Epstein-Barr Virus Antigens in Patients With Epstein-Barr Virus-Negative Hodgkin's Disease ONCOLOGY RESEARCH Kohrt, H., Johannsen, A., Hoppe, R., Horning, S. J., Rosenberg, S. A., Advani, R., Lee, P. P. 2009; 18 (5-6): 287-292

    Abstract

    In almost half of patients diagnosed with Hodgkin's disease (HD), the malignant Reed-Sternberg (RS) cells express Epstein-Barr virus (EBV) antigens. Multiple translational efforts are actively investigating antitumor immune strategies by stimulating cytotoxic T lymphocytes (CTL) against tumor-associated EBV antigens. It has previously been believed that this therapeutic strategy and presence of EBV-specific CTLs are limited to EBV-positive HD. In an effort to explore the EBV-specific immune response, here we characterize EBV-specific CTL responses to lytic and latent EBV antigens in 12 consecutive EBV carriers with EBV-negative HD. Compared to healthy donors, we detected weak, baseline EBV-specific responses to both lytic and latent antigens by IFN-gamma ELISPOT in patients with EBV-negative HD at diagnosis. Chemoradiotherapy was associated temporally with a decrease EBV-specific responses. At final follow-up (24 months), recovery of EBV-specific CTL responses was observed with robustness of lytic-specific response equivalent to healthy controls. We confirm evidence of EBV-specific CTLs in patients with EBV-negative HD and provide the first report of dynamic variance in this population during treatment. Our observation challenges prior belief that patients with HD remain immunodeficient following therapy and argues that the clinical significance of the EBV-specific immune response in EBV-negative HD should be further investigated.

    View details for DOI 10.3727/096504009X12596189659169

    View details for Web of Science ID 000274459900010

    View details for PubMedID 20225766

  • Lymphography: A Great Advance, Abandoned JOURNAL OF CLINICAL ONCOLOGY Rosenberg, S. A. 2008; 26 (35): 5662-5663

    View details for DOI 10.1200/JCO.2008.20.6946

    View details for Web of Science ID 000261528200001

    View details for PubMedID 19001339

  • Attitudes and beliefs towards surviorship issues in Hodgkin's disease (HD). Results of focus group discussions with patients treated at stanford university Advani, R., Rosenberg, S., Talreja, N., Hoppe, R., Horning, S. OXFORD UNIV PRESS. 2008: 137-137
  • Improved prognosis after histologic transformation (HT) of follicular lymphoma (FL): The Stanford experience 1960-2003 Tan, D., Rosenberg, S. A., Lavori, P., Levy, R., Hoppe, R., Warnke, R., Advani, R., Natkuunam, Y., Yuen, A., Horning, S. J. OXFORD UNIV PRESS. 2008: 111-112
  • Closing the gap: A comparison of observed versus expected survival in follicular lymphoma (FL) at Stanford University from 1960-2003 Tan, D., Rosenberg, S. A., Lavori, P., Sigal, B. M., Levy, R., Hoppe, R. T., Warnke, R., Advani, R., Natkunam, Y., Plevritis, S. K., Horning, S. J. AMER SOC CLINICAL ONCOLOGY. 2008
  • Follicular lymphoma revisited JOURNAL OF CLINICAL ONCOLOGY Rosenberg, S. A. 2008; 26 (4): 515-516

    View details for DOI 10.1200/JCO.2007.13.8131

    View details for Web of Science ID 000254177400001

    View details for PubMedID 18235110

  • Survival in follicular lymphoma: The Stanford experience, 1960-2003. Tan, D., Rosenberg, S. A., Levy, R., Lavori, P., Tibshirani, R., Hoppe, R. T., Warnke, R., Advani, R., Natkunam, Y., Yuen, A., Horning, S. J. AMER SOC HEMATOLOGY. 2007: 1005A-1005A
  • Stage I/II Hodgkin's disease: Comparison of outcomes of patients with bulky mediastinal disease versus other risk factors; the Stanford V experience Advani, R. H., Hoppe, R. T., Rosenberg, S. A., Horning, S. J. AMER SOC HEMATOLOGY. 2007: 685A-685A
  • A prospective trial of involved field radiation (IFRT) plus chemotherapy vs extended field (EFRT) radiation for favorable Hodgkin's disease (HD): Long-term follow-up and implications for current combined modality therapy Horning, S. J., Hoppe, R. T., Advani, R. H., Breslin, S., McCormick, E., Allen, J., Hancock, S. L., Rosenberg, S. A. FERRATA STORTI FOUNDATION. 2007: 53-53
  • Stage I/II Hodgkin's disease (HD) with bulky mediastinal disease or other risk factors (RF) the Stanford V experience Advani, R. H., Hoppe, R. T., Rosenberg, S. A., Horning, S. J. FERRATA STORTI FOUNDATION. 2007: 27-27
  • Impact of positive positron emission tomography on prediction of freedom from progression after Stanford V chemotherapy in Hodgkin's disease JOURNAL OF CLINICAL ONCOLOGY Advani, R., Maeda, L., Lavori, P., Quon, A., Hoppe, R., Breslin, S., Rosenberg, S. A., Horning, S. J. 2007; 25 (25): 3902-3907

    Abstract

    To correlate [(18)F]fluorodeoxyglucose positron emission tomography ([(18)F]FDG-PET) status after chemotherapy, but before radiation, with outcome in patients treated with the Stanford V regimen.We analyzed retrospectively 81 patients with Hodgkin's disease who had serial [(18)F]FDG-PET scans performed at baseline and again at the completion of Stanford V chemotherapy, before planned radiotherapy. Patients with favorable stage I/II (nonbulky mediastinal disease) and those with bulky mediastinal disease or stage III/IV were scanned after 8 and 12 weeks of chemotherapy, respectively. Radiotherapy fields were determined before starting chemotherapy based on baseline computed tomography scans.After chemotherapy, six of 81 patients had residual [(18)F]FDG-PET-positive sites, all in sites for which radiotherapy was planned. Four of the six patients with positive [(18)F]FDG-PET scans after chemotherapy experienced relapse compared with just three of 75 patients with negative [(18)F]FDG-PET scans. At a median follow-up of 4 years, the freedom from progression (FFP) was 96% in postchemotherapy [(18)F]FDG-PET-negative patients versus 33% in [(18)F]FDG-PET-positive patients (P < .0003). In a bivariate Cox model, [(18)F]FDG-PET positivity after chemotherapy remained a highly significant predictor of progression-free survival even after controlling for bulky disease and International Prognostic Score more than 2.These data indicate that PET status after chemotherapy is strongly predictive of FFP with the Stanford V regimen despite the use of consolidative radiotherapy. These results have implications for the design of clinical trials adapted to functional imaging.

    View details for DOI 10.1200/JCO.2007.11.9867

    View details for Web of Science ID 000249416000019

    View details for PubMedID 17664458

  • Splenic diffuse large B-cell lymphoma in a patient with type 1 Gaucher disease: diagnostic and therapeutic challenges ANNALS OF HEMATOLOGY Brody, J. D., Advani, R., Shin, L. K., Bingham, D. B., Rosenberg, S. A. 2006; 85 (11): 817-820

    View details for DOI 10.1007/s00277-006-0176-3

    View details for Web of Science ID 000240520100011

    View details for PubMedID 16937096

  • Incidence of secondary leukemia/myelodysplasia (AML/MDS) in Hodgkin's disease (HD) with three generations of therapy at Stanford University. Advani, R. H., Hoppe, R. T., Rosenberg, S. A., Horning, S. J. AMER SOC CLINICAL ONCOLOGY. 2006: 426S-426S
  • Assessment of favorable (F) versus unfavorable (U) early stage Hodgkin's disease (HD); the Stanford V plus radiotherapy (RT) experience. Advani, R., Maeda, L., Hoppe, R. T., Breslin, S., Rosenberg, S. A., Baer, D., Mason, J., Horning, S. J. AMER SOC HEMATOLOGY. 2005: 548A-548A
  • PET status after Stanford V chemotherapy predicts outcome in Hodgkins disease Advani, R., Maeda, L., Lavori, P., Hoppe, R., Breslin, S., Rosenberg, S., Horning, S. OXFORD UNIV PRESS. 2005: 121-121
  • Efficacy and late effects of Stanford V chemotherapy and radiotherapy in untreated Hodgkin's disease: Mature data in early and advanced stage patients. Horning, S. J., Hoppe, R. T., Advani, R., Warnke, R., Baer, D., Mason, J., Rosenberg, S. A. AMER SOC HEMATOLOGY. 2004: 92A-92A
  • Stage I and II follicular non-Hodgkin's lymphoma: Long-term follow-up of no initial therapy JOURNAL OF CLINICAL ONCOLOGY Advani, R., Rosenberg, S. A., Horning, S. J. 2004; 22 (8): 1454-1459

    Abstract

    To analyze the outcome of no initial therapy in stage I and II follicular small-cleaved (FSC) and follicular mixed (FM) non-Hodgkin's lymphoma (NHL) on overall survival, time to treatment, incidence and course of transformation, and cause of death.This was a retrospective analysis. Criteria for selection were patients with stage I and IIA FSC and FM (grades 1 and 2) NHL with therapy deferred for at least 3 months after diagnosis and a minimum follow-up of 1 year.Forty-three patients were identified (11 stage I, 32 stage II), with a median age of 58 years. Reasons for no initial therapy included: physician choice (n = 20), large abdominal radiation field required (n = 10), advanced age (n = 7), concern for xerostomia (n = 4), or patient refusal (n = 2). At a median follow-up of 86 months, 27 patients (63%) had not been treated. The median time to treatment in the remaining 16 patients was 22 months. Four of 16 patients transformed to a higher-grade lymphoma. Nine patients died-six due to progressive lymphoma. Estimated survivals at 5, 10, and 20 years were 97%, 85%, and 22%, respectively.In selected stage I and II follicular NHL patients, deferred therapy is an acceptable approach, as more than half of our patients remained untreated at a median of 6 or more years, and survival was comparable to that seen in reports with immediate treatment.

    View details for DOI 10.1200/JCO.2004.10.086

    View details for Web of Science ID 000220912200016

    View details for PubMedID 15024027

  • The dinB operon and spontaneous mutation in Escherichia coli JOURNAL OF BACTERIOLOGY McKenzie, G. J., Magner, D. B., Lee, P. L., Rosenberg, S. M. 2003; 185 (13): 3972-3977

    Abstract

    Apparently conflicting data regarding the role of SOS-inducible, error-prone DNA polymerase IV (DinB) in spontaneous mutation are resolved by the finding that mutation is reduced by a polar allele with which dinB and neighboring yafN are deleted but not by two nonpolar dinB alleles. We demonstrate the existence of a dinB operon that contains four genes, dinB-yafN-yafO-yafP. The results imply a role for yafN, yafO, and/or yafP in spontaneous mutation.

    View details for DOI 10.1128/JB.182.13.3972-3799.2003

    View details for Web of Science ID 000183667600035

    View details for PubMedID 12813093

  • Stanford V and radiotherapy for locally extensive and advanced Hodgkin's disease: Mature results of a prospective clinical trial JOURNAL OF CLINICAL ONCOLOGY Horning, S. J., Hoppe, R. T., Breslin, S., Bartlett, N. L., Brown, B. W., Rosenberg, S. A. 2002; 20 (3): 630-637

    Abstract

    To provide more mature data on the efficacy and complications of a brief, dose-intense chemotherapy regimen plus radiation therapy (RT) to bulky disease sites for locally extensive and advanced-stage Hodgkin's disease.One hundred forty-two patients with stage III or IV or locally extensive mediastinal stage I or II Hodgkin's disease received Stanford V chemotherapy for 12 weeks followed by 36-Gy RT to initial sites of bulky (> or =5 cm) or macroscopic splenic disease. Freedom from progression (FFP), overall survival (OS), and freedom from second relapse (FF2R) were determined using life-table estimates. Outcomes were analyzed according to the international prognostic score. Late effects of treatment were recorded in follow-up.With a median follow-up of 5.4 years, the 5-year FFP was 89% and the OS was 96%. No patient progressed during treatment, and there were no treatment-related deaths. FFP was significantly superior among patients with a prognostic score of 0 to 2 compared with those with a score of 3 and higher (94% v 75%, P <.0001). No secondary leukemia was observed. To date, there have been 42 pregnancies after treatment. Among 16 patients who relapsed, the FF2R was 69% at 5 years.These data confirm our preliminary report that Stanford V chemotherapy with RT to bulky disease sites is highly effective in locally extensive and advanced Hodgkin's disease. It is most important to compare this approach with standard doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy in the ongoing intergroup trial (E2496) to determine whether Stanford V with or without RT represents a therapeutic advance.

    View details for Web of Science ID 000173669400007

    View details for PubMedID 11821442

  • Update on a comparison between conventional salvage therapy and high-dose therapy with autografting for recurrent or refractory Hodgkin's disease. Yuen, A. R., Blume, K. G., Rosenberg, S. A., Hoppe, R. T., Chao, N. J., Long, G. D., Horning, S. J. AMER SOC HEMATOLOGY. 2001: 401B-401B
  • High-dose therapy and autologous bone marrow transplantation for follicular lymphoma in first complete or partial remission: results of a phase II clinical trial BLOOD Horning, S. J., Negrin, R. S., Hoppe, R. T., Rosenberg, S. A., Chao, N. J., Long, G. D., Brown, B. W., Blume, K. G. 2001; 97 (2): 404-409

    Abstract

    Advanced stage follicular small cleaved and mixed cell lymphoma is characterized by relapse from remission and survival ranging from 6 to 12 years. Because young patients have the greatest compromise in longevity, the efficacy and toxicity of high-dose radiochemotherapy and bone marrow transplantation after conventional chemotherapy was evaluated in a prospective phase II clinical trial. Thirty-seven patients in a minimal disease state after conventional chemotherapy received fractionated total body irradiation and high-dose etoposide and cyclophosphamide, followed by purged autologous bone marrow. A reference sample of 188 patients of similar age, stage, and histology managed at this institution before 1988 was identified for comparison of patient characteristics and outcomes. Compared with reference patients, transplant recipients had a higher tumor burden at diagnosis. With a median follow-up of 6.5 years, the estimated 10-year survival after transplantation was 86%. There was a single lymphoma death yielding a 10-year disease-specific survival of 97%. There were 2 early transplant-related deaths and 2 late acute leukemia deaths. Ten patients relapsed, one with microscopic disease only. High tumor burden at diagnosis and incomplete response to chemotherapy adversely influenced survival in the reference but not in the transplanted patients. The estimated risk of death of 14% and relapse of 30% at 10 years in our transplanted follicular lymphoma patients, the majority of whom had high tumor burdens, compares favorably with our observations in appropriately matched reference patients.

    View details for Web of Science ID 000166388000011

    View details for PubMedID 11154216

  • Very brief (8 week) chemotherapy (CT) and low dose (30 Gy) radiotherapy (RT) for limited stage Hodgkin's disease (HD): Preliminary results of the Stanford-Kaiser G4 study of Stanford V plus RT. Horning, S. J., Hoppe, R. T., Breslin, S., Baer, D. M., Mason, J., Rosenberg, S. A. AMER SOC HEMATOLOGY. 1999: 387A-387A
  • Treatment of multicentric Castleman's disease complicated by the development of non-Hodgkin's lymphoma with high-dose chemotherapy and autologous peripheral stem-cell support ANNALS OF ONCOLOGY Advani, R., Warnke, R., Rosenberg, S. 1999; 10 (10): 1207-1209

    Abstract

    Castleman's disease or angiofollicular lymph node hyperplasia is a rare entity with a localized/unicentric or a generalized/multicentric presentation. While surgery is curable for most localized presentations, there is limited information regarding the optimal management of the multicentric type. The latter type is associated with a poor prognoses and can be associated with the development of lymphoma and infections.In this report we describe a case of multicentric Castleman's disease who failed steroids and chemotherapy and developed a follicular mixed lymphoma. He was treated with high-dose chemotherapy with autologous stem-cell support and remains disease at four years of follow-up.A long-term durable remission may be possible with high dose chemotherapy with stem-cell support. This treatment modality should be considered an option in the management of multicentric Castleman's disease.

    View details for Web of Science ID 000083272400014

    View details for PubMedID 10586338

  • Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity JOURNAL OF CLINICAL ONCOLOGY Yang, J. C., Chang, A. E., BAKER, A. R., SINDELAR, W. F., Danforth, D. N., Topalian, S. L., Delaney, T., Glatstein, E., STEINBERG, S. M., MERINO, M. J., Rosenberg, S. A. 1998; 16 (1): 197-203

    Abstract

    This randomized, prospective study assesses the impact of postoperative external-beam radiation therapy on local recurrence (LR), overall survival (OS), and quality of life after limb-sparing resection of extremity sarcomas.Patients with extremity tumors and a limb-sparing surgical option were randomized to receive or not receive postoperative adjuvant external-beam radiotherapy. Patients with high-grade sarcomas received postoperative adjuvant chemotherapy whereas patients with low-grade sarcomas or locally aggressive nonmalignant tumors were randomized after surgery alone.Ninety-one patients with high-grade lesions were randomized; 47 to receive radiotherapy (XRT) and 44 to not receive XRT. With a median follow-up of 9.6 years, a highly significant decrease (P2 = .0028) in the probability of LR was seen with radiation, but no difference in OS was shown. Of 50 patients with low-grade lesions (24 randomized to resection alone and 26 to resection and postoperative XRT), there was also a lower probability of LR (P2 = .016) in patients receiving XRT, again, without a difference in OS. A concurrent quality-of-life study showed that extremity radiotherapy resulted in significantly worse limb strength, edema, and range of motion, but these deficits were often transient and had few measurable effects on activities of daily life or global quality of life.This study indicates that although postoperative external-beam radiotherapy is highly effective in preventing LRs, selected patients with extremity soft tissue sarcoma who have a low risk of LR may not require adjuvant XRT after limb-sparing surgery (LSS).

    View details for Web of Science ID 000071368500030

    View details for PubMedID 9440743

  • High dose therapy and autografting for follicular low grade lymphoma in first remission: The Stanford experience. Horning, S. J., Negrin, R. S., Hoppe, R. T., Chao, N. J., Long, G. D., Rosenberg, S. A., Tierney, K., Blume, K. G. AMER SOC HEMATOLOGY. 1997: 2641-2641
  • Stanford-Kaiser permanente G1 study for clinical stage I to IIA Hodgkin's disease: Subtotal lymphoid irradiation versus vinblastine, methotrexate, and bleomycin chemotherapy and regional irradiation JOURNAL OF CLINICAL ONCOLOGY Horning, S. J., Hoppe, R. T., Mason, J., Brown, B. W., Hancock, S. L., Baer, D., Rosenberg, S. A. 1997; 15 (5): 1736-1744

    Abstract

    We have demonstrated that a relatively mild chemotherapy regimen, vinblastine, methotrexate, and bleomycin (VBM), and involved-field radiotherapy (IFRT) could substitute for extended-field radiotherapy in patients with favorable Hodgkin's disease (HD) who have been laparotomy-staged. The purpose of this study is to determine if VBM and regional radiotherapy can substitute for extended-field radiotherapy in favorable clinical stage (CS) I and II HD.Seventy-eight patients with favorable CS I to II HD were randomly assigned to subtotal lymphoid irradiation (STLI) or VBM chemotherapy and regional radiotherapy. Randomization was stratified on the basis of age, sex, number of Ann Arbor sites, histology, and institution. Patients were evaluated for freedom from progressive HD, survival, and toxicity. Results were compared with the predecessor trial in pathologically staged patients.With a median follow-up period of 4 years, the rate of freedom from progressive HD was 92% (95% confidence interval [CI], 88% to 96%) for patients treated with STLI and 87% (95% CI, 81% to 93%) for patients treated with VBM and regional radiotherapy. Six of seven patients who relapsed are alive and in remission following successful second-line therapy.Given the caveat of a small number of patients, the results of extended-field radiotherapy and VBM and regional radiotherapy are comparable with a median follow-up period of 4 years. VBM serves as a paradigm to reduce late effects in favorable early-stage HD. We do not advocate its routine use in clinical practice, but instead encourage participation in clinical trials with the objective of maintaining efficacy while reducing toxicity in CS I and II HD.

    View details for Web of Science ID A1997WZ56400006

    View details for PubMedID 9164180

  • Comparison between conventional salvage therapy and high-dose therapy with autografting for recurrent or refractory Hodgkin's disease BLOOD Yuen, A. R., Rosenberg, S. A., Hoppe, R. T., HALPERN, J. D., Horning, S. J. 1997; 89 (3): 814-822

    Abstract

    Sixty patients with Hodgkin's disease, refractory to or at first recurrence after chemotherapy, received cytoreductive therapy followed by high-dose etoposide, cyclophosphamide and either total body irradiation or carmustine and autografting (median follow-up, 3.6 years; range, 1.1 to 7.5 years). A matched conventional salvage group of 103 patients was selected from patients treated at Stanford University Medical Center between January 1976 and January 1989 (median follow-up, 10.3 years; range, 3.0 to 15.7 years). Overall survival (OS), event-free survival (EFS), and freedom from progression (FFP) at 4 years follow-up favored patients who received high-dose therapy compared with conventional salvage treatment (OS: 54% v 47%, P = .25; EFS: 53% v 27%, P < .01; FFP: 62% v 32%, P < .01). In Cox regression analysis, response to cytoreductive or salvage therapy and B symptoms at relapse were the most important predictors of OS. The use of high-dose therapy at relapse, a longer duration of remission, and favorable response to cytoreductive or salvage therapy were most predictive of superior FFP and EFS. These data from a single institution comparing conventional and high-dose therapy in matched patients demonstrate an advantage for high-dose therapy and autografting in the sustained control of Hodgkin's disease. As with primary therapy, it is difficult to demonstrate a statistically significant survival advantage, despite an apparently superior cure rate. However, patients failing induction therapy or relapsing within 1 year benefited significantly from high-dose therapy by all outcome measures (OS, EFS, FFP). As the transplant-related mortality rates decline in Hodgkin's disease, it is predicted that cure rates and late effects will become ultimate determinants of the success of high-dose therapy and autografting.

    View details for Web of Science ID A1997WG07300009

    View details for PubMedID 9028312

  • The management of Hodgkin's disease: Half a century of change - The Kaplan Memorial Lecture ANNALS OF ONCOLOGY Rosenberg, S. A. 1996; 7 (6): 555-560

    Abstract

    The results of treating more than 2600 patients with Hodgkin's disease at Stanford over a 35-year period are summarized. It is now a reality that Hodgkin's disease can be cured with initial treatment programs in virtually all patients, except the elderly. Histologic factors, staging methods, and prognostic groups are becoming less and less relevant. The current protocols used at Stanford and elsewhere will be reviewed to emphasize that combined modality is really the key to improving the cure rate and minimizing late complications.

    View details for Web of Science ID A1996VG53400009

    View details for PubMedID 8879367

  • BRIEF CHEMOTHERAPY, STANFORD-V, AND ADJUVANT RADIOTHERAPY FOR BULKY OR ADVANCED-STAGE HODGKINS-DISEASE - A PRELIMINARY-REPORT JOURNAL OF CLINICAL ONCOLOGY Bartlett, N. L., Rosenberg, S. A., Hoppe, R. T., Hancock, S. L., Horning, S. J. 1995; 13 (5): 1080-1088

    Abstract

    Although survival rates have improved for patients with bulky and advanced-stage Hodgkin's disease (HD), current treatments entail substantial acute morbidity and risks for late effects such as infertility, second malignancies, and cardiopulmonary toxicities. A novel, brief chemotherapy regimen (doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, and prednisone [Stanford V]) was designed to shorten the duration of treatment, significantly reduce cumulative doses of alkylating agents, doxorubicin, and bleomycin, and maintain dose-intensity (DI). This brief chemotherapy was combined with radiation therapy (RT) to bulky disease sites.Since May 1989, 65 previously untreated patients were treated for stage II HD with bulky mediastinal involvement (n = 21) or for stage III or IV HD (n = 44). Patients received weekly chemotherapy for 12 weeks. Consolidative RT was given to the first 25 patients to sites of initial bulky disease or radiographic abnormalities that persisted after chemotherapy; in the remaining 40 patients, RT was limited to bulky disease (adenopathy > or = 5 cm and/or macroscopic splenic nodules defined by computed tomography [CT]).With a median follow-up period of 2 years, actuarial 3-year survival rate is 96% and failure-free survival (FFS) rate is 87%. The 3-year FFS rate is 100% for stage II patients with bulky mediastinal disease and 82% for patients with stage III to IV disease. There were no treatment-related deaths. In a preliminary analysis on a subset of patients, female and male fertility appears to be preserved.These preliminary results indicate that the Stanford V chemotherapy regimen with or without RT is well-tolerated and effective therapy for bulky, limited-stage, and advanced-stage HD. Less cumulative exposure to alkylating agents, doxorubicin, and bleomycin and limited use of radiation is expected to decrease risks for second neoplasms and late cardiopulmonary toxicity. Based on these results, the Stanford V chemotherapy with or without RT regimen deserves further study in the context of a randomized clinical trial.

    View details for Web of Science ID A1995QV95100006

    View details for PubMedID 7537796

  • COMPARISON BETWEEN AUTOLOGOUS BONE-MARROW TRANSPLANTATION (ABMT) AND CONVENTIONAL SALVAGE THERAPY FOR RECURRENT OR REFRACTORY HODGKINS-DISEASE Yuen, A. R., Blume, K. G., Rosenberg, S. A., Hoppe, R. T., Chao, N. J., Negrin, R. S., Long, G. D., Horning, S. J. AMER SOC HEMATOLOGY. 1994: A234-A234
  • A CLINICAL AND EPIDEMIOLOGIC-STUDY OF HUMAN-LEUKOCYTE ANTIGEN-DPB ALLELES IN HODGKINS-DISEASE CANCER RESEARCH Oza, A. M., Tonks, S., Lim, J., FLEETWOOD, M. A., Lister, T. A., Bodmer, J. G., Howell, W. M., Devereux, S., Taylor, G. M., GOKALE, D., Loeliger, C., Kuehnl, P., Pellegris, G., Takacs, K., Petranyi, G., Gazit, E., Klein, T., Dutoit, E., Martell, R., Hammond, M. G., VANTONDER, S. V., Liang, R., Wong, T., Chan, V., Klitz, W., Begovich, A., Woodfield, G., Roberts, M., Bignon, J. D., Mikata, A., Takenouchi, T., Cunningham, D., Robinson, E., Haim, N., Chen, P. M., Ferreira, E., Whitehouse, J. M., Sweetenham, J., Mead, G. M., Crowther, D., Woll, P., ZELLER, W., Hossfeld, D. K., KUSE, W., Bonadonna, G., Molnar, Z., ECKHARDT, S., BENBASSAT, I., Jacobs, P., Johnson, C., KENOYER, D. J., Todd, D., Chan, T. K., Horning, S., Rosenberg, S., Harvey, V., Thompson, P., Browett, P., Harousseau, J. L. 1994; 54 (19): 5101-5105
  • CLASSIFICATION OF LYMPHOID NEOPLASMS BLOOD Rosenberg, S. A. 1994; 84 (5): 1359-1360

    View details for Web of Science ID A1994PE38700001

    View details for PubMedID 8068935

  • Modern combined modality management of Hodgkin's disease. Current opinion in oncology Rosenberg, S. A. 1994; 6 (5): 470-472

    Abstract

    The combination of chemotherapy and irradiation in the management of patients with Hodgkin's disease is being reported with increased frequency. In some situations, higher cure rates have been achieved with combined modality. In other situations, a reduction or modification of one or both modalities has reduced the acute toxicity (and later morbidity) of successful therapy.

    View details for PubMedID 7827149

  • The treatment of Hodgkin's disease. Annals of oncology Rosenberg, S. A. 1994; 5: 17-21

    View details for PubMedID 8204516

  • THE TREATMENT OF HODGKINS-DISEASE ANNALS OF ONCOLOGY Rosenberg, S. A. 1994; 5: S17-S21
  • 12-WEEKS OF CHEMOTHERAPY AND INVOLVED FIELD RADIOTHERAPY (RT) ARE HIGHLY EFFECTIVE FOR UNFAVORABLE HODGKINS-DISEASE (HD) - THE STANFORD V REGIMEN Barlett, N. L., Rosenberg, S. A., Hoppe, R. T., Horning, S. J. AMER SOC HEMATOLOGY. 1993: A333-A333
  • THE STANFORD EXPERIENCE WITH COMBINED PROCARBAZINE, ALKERAN AND VINBLASTINE (PAVE) AND RADIOTHERAPY FOR LOCALLY EXTENSIVE AND ADVANCED STAGE HODGKINS-DISEASE ANNALS OF ONCOLOGY Horning, S. J., Ang, P. T., Hoppe, R. T., Rosenberg, S. A. 1992; 3 (9): 747-754

    Abstract

    This report describes the efficacy and toxicity of PAVe (procarbazine, Alkeran, vinblastine) and irradiation (RT) in the management of 159 patients with locally extensive or advanced stage Hodgkin's disease (HD) at Stanford University. Patients received six courses of chemotherapy alternating with RT. The extent of RT and the schedule of treatment varied according to the stage of disease. About 2/3 of patients received PAVe/RT in the setting of prospective, randomized clinical trials. The rate of complete response was 93%. With a median follow-up of seven years (range 2-17), the 15 year actuarial freedom from progression (FFP) is 78% and overall survival is 75%. Ten-year FFP by stage is: 80% for locally extensive stage II, 90% for stage IIIA and 70% for stage IIIB. Excellent and equal results were attained with PAVe/RT vs. MOP(P) (mustard, Oncovin, procarbazine with or without prednisone)/RT in the randomized combined modality studies. Progression or recurrence was documented in 30 patients and was more common in irradiated sites. PAVe was well tolerated acutely. There were no treatment related fatalities. Twenty-three (14%) patients were admitted to the hospital for neutropenic fever. Five second malignancies have occurred after PAVe/RT only: one myelodysplastic syndrome, one acute myelogenous leukemia, one non-Hodgkin's lymphoma and two solid tumors including a case of non-small cell lung cancer and an in situ carcinoma of the cervix. Three patients died from myocardial infarction several years after the completion of treatment. These mature data show that PAVe/RT is effective and well-tolerated therapy for locally extensive stage II and IIIA/B HD.(ABSTRACT TRUNCATED AT 250 WORDS)

    View details for Web of Science ID A1992JW88200021

    View details for PubMedID 1450064

  • REDUCING THE TOXICITY OF THE COMBINED MODALITY THERAPY OF FAVORABLE STAGE HODGKINS-DISEASE EUROPEAN JOURNAL OF CANCER Rosenberg, S. A. 1992; 28A (8-9): 1379-1380

    View details for Web of Science ID A1992JC98100023

    View details for PubMedID 1515253

  • DEATHS AFTER TREATMENT OF HODGKIN DISEASE - CORRECTION ANNALS OF INTERNAL MEDICINE Hancock, S. L., Cox, R. S., Rosenberg, S. A. 1991; 114 (9): 810-810
  • CEPP(B) - AN EFFECTIVE AND WELL-TOLERATED REGIMEN IN POOR-RISK, AGGRESSIVE NON-HODGKINS-LYMPHOMA BLOOD Chao, N. J., Rosenberg, S. A., Horning, S. J. 1990; 76 (7): 1293-1298

    Abstract

    Eighty-three patients with intermediate- or high-grade non-Hodgkin's lymphoma were treated with CEPP(B) (cyclophosphamide, etoposide [VP-16], procarbazine, and prednisone with or without bleomycin) chemotherapy at Stanford University Medical Center (Stanford, CA) from January 1982 through June 1989. Sixty-nine received CEPP(B) as second-line or subsequent therapy after relapse from previous combination chemotherapy, and 14 patients received CEPP(B) as first-line therapy. Of 75 patients evaluable for response, 30 patients (40%) achieved a complete response (CR) and 24 patients (32%) achieved a partial response (PR), providing an overall response rate of 72%. Complete responses were recorded on 21 of 61 (34%) patients with recurrent disease and 9 of the 14 patients who received CEPP(B) as first line therapy (64%). Myelosuppression was the major side effect of treatment, resulting in eight neutropenic-febrile episodes from a total of 253 courses. A single fatal toxic event occurred on a patient who developed adult respiratory distress syndrome. Overall, CEPP(B) was well-tolerated and proved to be effective palliative therapy for patients with non-Hodgkin's lymphoma after relapse. As such, CEPP(B) may be considered for cytoreduction before ablative therapy and bone marrow transplantation. CEPP(B) may also be considered for initial therapy in selected patients who cannot tolerate doxorubicin-containing regimens.

    View details for Web of Science ID A1990EB07800005

    View details for PubMedID 2207307

  • HODGKINS-DISEASE - CHALLENGES FOR THE FUTURE CANCER RESEARCH Rosenberg, S. A. 1989; 49 (4): 767-769

    Abstract

    Clinical investigators of Hodgkin's disease of the recent past have reason to be proud. Tens of thousands of individuals, many of them young, fertile, and productive, have been cured of their life-threatening disease. There are few better examples of the success and rewards of clinical oncology than in the control of Hodgkin's disease by improved diagnostic methods and the appropriate use of radiation and chemotherapy. Yet the clinical investigator of today cannot be satisfied with these successes. The treatment required for high cure rates remains empirical, difficult, and costly. The goal must be to prevent or reverse this fascinating disease, utilizing specific therapy designed from a knowledge of the cause and pathogenesis of the disease. There are sufficient biological clues and methodologies to predict that this will be possible, and in the decade of the 1990s!

    View details for Web of Science ID A1989T082400001

    View details for PubMedID 2643461

  • Current Stanford clinical trials for Hodgkin's disease. Recent results in cancer research. Fortschritte der Krebsforschung. Progrès dans les recherches sur le cancer Hoppe, R. T., Horning, S. J., Hancock, S. L., Rosenberg, S. A. 1989; 117: 182-190

    View details for PubMedID 2690227

  • PROGNOSTIC INDICATORS OF LAPAROTOMY FINDINGS IN CLINICAL STAGE-I-II SUPRADIAPHRAGMATIC HODGKINS-DISEASE JOURNAL OF CLINICAL ONCOLOGY LEIBENHAUT, M. H., Hoppe, R. T., Efron, B., Halpern, J., Nelsen, T., Rosenberg, S. A. 1989; 7 (1): 81-91

    Abstract

    Between July 1968 and July 1986, 915 patients with clinical stage (CS) I and II Hodgkin's disease limited to sites above the diaphragm underwent laparotomy and splenectomy at Stanford University. Fifteen percent were CS I, of whom 76% had cervical/supraclavicular disease, 13% axillary disease, and 9% mediastinal presentations. CS I patients were more likely to be male, were significantly older, and were significantly less likely to have nodular sclerosis (NS) histology than CS II patients. Twenty percent of CS I patients and 30% of CS II patients were pathologically upstaged. No CS I patients were upstaged to pathological stage (PS) IV. Univariate and multivariate analyses of presenting clinical characteristics were performed to predict staging laparotomy findings. CS I women, CS I patients with mediastinal-only disease, and CS I men with either lymphocyte predominance or interfollicular histologies were at low risk for having disease below the diaphragm (5%) or requiring chemotherapy (0%). CS II women who were less than 27 years old and had only two or three sites of disease were also at low risk for upstaging (9%) or requiring chemotherapy (2%). Mixed cellularity histology and male gender were associated with increased risk for subdiaphragmatic disease and require laparotomy; the presence of systemic symptoms was not correlated with laparotomy findings. These results confirm the importance of performing staging laparotomy for the majority of patients who present with supradiaphragmatic Hodgkin's disease if treatment programs are based on the presence and extent of subdiaphragmatic disease. Selected subgroups are at low risk for subdiaphragmatic disease and might be spared laparotomy if they are treated with mantle, paraaortic, and splenic irradiation.

    View details for Web of Science ID A1989R711000012

    View details for PubMedID 2909669

  • VINBLASTINE, BLEOMYCIN, AND METHOTREXATE - AN EFFECTIVE ADJUVANT IN FAVORABLE HODGKINS-DISEASE JOURNAL OF CLINICAL ONCOLOGY Horning, S. J., Hoppe, R. T., Hancock, S. L., Rosenberg, S. A. 1988; 6 (12): 1822-1831

    Abstract

    Sixty-seven patients with favorable pathologic stage (PS) I and IIA or B or IIIA Hodgkin's disease were randomized to receive subtotal or total lymphoid irradiation (STLI/TLI) alone or involved field irradiation (IF) plus six cycles of a novel adjuvant chemotherapy containing vinblastine, bleomycin, and methotrexate (VBM). With a follow-up from 6 to 72 months (median, 37 months), the actuarial freedom-from-progressive disease (FFP) at 5 years is 70% after STLI/TLI and 95% after IF plus VBM. One death has occurred in the irradiation-only treatment group. The data for IF plus VBM are significantly superior to previous actuarial results at 5 years using IF alone (FFP = 35%, P less than .00001) and compare favorably with prior results with IF plus nitrogen mustard, vincristine, procarbazine, +/- prednisone (MOP[P]) chemotherapy (FFP = 80% at 5 years, P = .10). VBM is well tolerated with greater than 90% of calculated doses delivered. As anticipated, VBM has had relatively little adverse effect on male or female fertility. Selected pulmonary functions are reduced early after IF plus VBM to a greater degree than with irradiation of the mediastinum alone, but the differences are modest. Based upon our current numbers and follow-up, we can be 90% confident that VBM as an adjuvant to irradiation in favorable Hodgkin's disease is as effective, or even superior, to MOP(P) chemotherapy. Because of its lesser toxicity, adjuvant VBM may have a broader role in the management of Hodgkin's disease.

    View details for Web of Science ID A1988R308000006

    View details for PubMedID 2462025

  • INTERCURRENT DEATH AFTER HODGKIN DISEASE THERAPY IN RADIOTHERAPY AND ADJUVANT MOPP TRIALS ANNALS OF INTERNAL MEDICINE Hancock, S. L., Hoppe, R. T., Horning, S. J., Rosenberg, S. A. 1988; 109 (3): 183-189

    Abstract

    To assess long-term differences in mortality associated with initial Hodgkin disease therapy.Retrospective review of patients treated in prospectively randomized clinical trials.Three hundred twenty-six patients with pathologic stage I, II, or III, A or B Hodgkin disease treated between 1967 and 1980 with median follow-up exceeding 14 years.Patients at the same stage of disease were randomized to receive radiation alone (167 patients) or radiation followed by 6 cycles of mechlorethamine hydrochloride, vincristine, procarbazine, and prednisone (MOPP) chemotherapy (159 patients) with additional therapy for progression or recurrence.No significant differences between treatment regimens for actuarial survival, intercurrent disease, or Hodgkin disease mortality were seen. Thirty-three patients who received radiation alone and 30 patients who received adjuvant chemotherapy died without evident Hodgkin disease. Death was caused by second neoplasms in 28 patients (relative risk, 2.35; 95% CI, 1.46 to 3.24). Six patients developed acute myelogenous leukemia or a myeloproliferative disorder after treatment including MOPP. Chemotherapy exposure varied among the 8 patients with lung cancers, 6 with gastrointestinal and 3 with other adenocarcinomas, 3 with sarcomas, 1 with diffuse large cell lymphoma, and 1 with melanoma. Acute myocardial infarction caused 9 of 17 cardiovascular disease deaths with 5 occurring in patients between the ages of 33 and 43. Nonetheless, the risk for acute myocardial infarction was not clearly increased (relative risk, 0.86; 95% CI, 0.42 to 1.57). Fifteen patients died from infection: 5, opportunistic; 5, asplenic sepsis; and 5, other pneumonias. Two patients died in accidents, and 1 died from radiation pneumonitis.Adjuvant MOPP chemotherapy improved freedom from relapse without significant survival benefit or impairment. Leukemogenesis was the only lethal complication associated with MOPP. Survivors of Hodgkin disease had an increased risk for death from a second neoplasm, but no apparent increased risk for death from acute myocardial infarction.

    View details for Web of Science ID A1988P606500005

    View details for PubMedID 3291657

  • EXPLORATORY LAPAROTOMY AND SPLENECTOMY FOR HODGKINS-DISEASE - A COMMENTARY JOURNAL OF CLINICAL ONCOLOGY Rosenberg, S. A. 1988; 6 (4): 574-575

    View details for Web of Science ID A1988N007300002

    View details for PubMedID 3357003

  • SUBDIAPHRAGMATIC HODGKINS-DISEASE - LAPAROTOMY AND TREATMENT RESULTS IN 49 PATIENTS JOURNAL OF CLINICAL ONCOLOGY LEIBENHAUT, M. H., Hoppe, R. T., Varghese, A., Rosenberg, S. A. 1987; 5 (7): 1050-1055

    Abstract

    The clinical records of 1,616 patients with previously untreated Hodgkin's disease were reviewed. Forty-nine of these patients (3%) presented with disease limited to sites below the diaphragm and underwent laparotomy as part of their staging evaluation. The clinical and histological characteristics of this group of patients with subdiaphragmatic Hodgkin's disease are compared with those who presented with supradiaphragmatic disease. Splenectomy in 47 patients revealed splenic involvement in 16 (39%), and bulky splenic involvement (more than five gross nodules) in ten (24%). The final pathological stage (PS) distribution was PS I = 8, PS II = 37, PS IV = 4. No clinical stage (CS) IA patients and only two of 20 patients with negative paraaortic nodes on lymphogram had splenic involvement in contrast to eight of nine CS IIB patients. Freedom from relapse and survival were similar to patients with equivalent stage supradiaphragmatic disease. Splenic involvement and bulky splenic involvement were associated with a significantly decreased survival. Twelve out of 44 PS IA to IIB patients relapsed. In eight of these 12 patients, relapse was limited to sites above the diaphragm and another two patients relapsed both above and below the diaphragm. Patients who received total lymphoid irradiation were less likely to relapse above the diaphragm than patients who received no supradiaphragmatic irradiation. We recommend that CS IA and IIA patients with subdiaphragmatic disease undergo staging laparotomy and receive supradiaphragmatic irradiation as part of their treatment. Laparotomy may not be necessary for CS IIB patients who are at high risk for splenic disease if chemotherapy is planned as part of their treatment program.

    View details for Web of Science ID A1987J134800011

    View details for PubMedID 3598609

  • HODGKINS-DISEASE - NO STAGE BEYOND CURE HOSPITAL PRACTICE Rosenberg, S. A. 1986; 21 (8): 91-?

    View details for Web of Science ID A1986E107000015

    View details for PubMedID 3090078

  • STAGE-IIB HODGKINS-DISEASE - THE STANFORD EXPERIENCE JOURNAL OF CLINICAL ONCOLOGY CRNKOVICH, M. J., Hoppe, R. T., Rosenberg, S. A. 1986; 4 (4): 472-479

    Abstract

    Between 1968 and 1982, 126 patients with pathologic stage (PS) IIB Hodgkin's disease were treated at Stanford University with either irradiation alone or irradiation combined with chemotherapy. Actuarial survival and freedom from relapse rates at 10 years for the overall group were 81% and 74% respectively, with no statistically significant difference between the treatment approaches. The impact of the severity and number of constitutional (B) symptoms, as defined by the Ann Arbor Conference, was analyzed. Patients who presented with all three B symptoms had significantly poorer survival and freedom from relapse compared with those patients with only one or two B symptoms (for survival differences, P = .005 and .007; for freedom from relapse differences, P = .002 and .04). Male sex was the only other prognostic factor that correlated with a poor outcome. At 10 years, the survival rate was 66% for males v 84% for females (P = .01), and the freedom from relapse rate was 75% for males v 89% for females (P = .02). The presence of extralymphatic sites of involvement, age greater than 40, or involvement of greater than three lymphoid sites had no significant adverse effect on either freedom from relapse or survival. Patients with large mediastinal masses treated with irradiation alone had a 10-year freedom from relapse rate of 54% v 81% for those treated with combined-modality therapy (P = .15), but there was no significant difference in survival rates (85% for irradiation alone v 71% for combined modality therapy). Treatment recommendations for stage IIB Hodgkin's disease are discussed.

    View details for Web of Science ID A1986A743500005

    View details for PubMedID 3958761

  • KARNOFSKY MEMORIAL LECTURE - THE LOW-GRADE NON-HODGKINS LYMPHOMAS - CHALLENGES AND OPPORTUNITIES JOURNAL OF CLINICAL ONCOLOGY Rosenberg, S. A. 1985; 3 (3): 298-310
  • LATE RELAPSE AMONG PATIENTS TREATED FOR HODGKINS-DISEASE ANNALS OF INTERNAL MEDICINE Herman, T. S., Hoppe, R. T., Donaldson, S. S., Cox, R. S., Rosenberg, S. A., KAPLAN, H. S. 1985; 102 (3): 292-297

    Abstract

    Of 1360 consecutive patients with Hodgkin's disease treated at Stanford University, 1312 patients (96%) had complete remission, but 424 patients had a relapse. Fifty-five patients had relapses 36 months or more after completion of therapy. The actuarial risk of relapse in patients disease-free 3 years after therapy was 12.9%. The occurrence of late relapse was significantly related to stage I disease and nodular sclerosis histologic subtype. Late relapse was detected in 88% of patients by history, physical findings, or chest radiographs. Most patients with stage III and IV disease had late relapses in previously irradiated nodes or extranodally, but patients with stage I and II disease had late relapses primarily in unirradiated nodes. Disease-free survival after salvage therapy for late relapse was similar to that seen after treatment of earlier relapse. Prolonged surveillance of patients for late relapse is necessary after treatment of patients with Hodgkin's disease.

    View details for Web of Science ID A1985ACZ2400002

    View details for PubMedID 3970468

  • THE CONCEPT, EVOLUTION AND PRELIMINARY-RESULTS OF THE CURRENT STANFORD CLINICAL-TRIALS FOR HODGKINS-DISEASE CANCER SURVEYS Hoppe, R. T., Horning, S. J., Rosenberg, S. A. 1985; 4 (2): 459-475

    View details for Web of Science ID A1985AXK0700010

    View details for PubMedID 3916086

  • HODGKINS-DISEASE IN PATIENTS OVER 60 YEARS OLD ANNALS OF INTERNAL MEDICINE AUSTINSEYMOUR, M. M., Hoppe, R. T., Cox, R. S., Rosenberg, S. A., KAPLAN, H. S. 1984; 100 (1): 13-18

    Abstract

    Fifty-two patients 60 to 75 years of age were treated for Hodgkin's disease at Stanford University between 1968 and 1980. Adequate staging was defined as including a lymphogram and staging laparotomy for stage I to III and a positive bone marrow or liver biopsy or other evidence of diffuse involvement of extralymphatic tissues for stage IV. Adequate treatment was defined as subtotal lymphoid irradiation for pathologic stages I to IIA; total lymphoid irradiation for stages IIB to IIIA; and chemotherapy with or without irradiation for stages IIIB to IV. Twenty-four patients (46%) had advanced disease (IIIB to IV). Those patients who received appropriate treatment had a median survival of only 39 months. Of the 28 patients with limited disease (I to IIIA), 15 had laparotomy and adequate treatment. Thirteen did not have a laparotomy and 7 were treated with involved-field irradiation. The 5-year survival rate in the laparotomy-staged and adequately treated group was 86%, but in the clinically staged group, only 35% (p = 0.006).

    View details for Web of Science ID A1984RY26100003

    View details for PubMedID 6691638

  • PREDICTIVE VALUE OF LYMPHOGRAPHY FOR SITES OF SUBDIAPHRAGMATIC DISEASE ENCOUNTERED AT STAGING LAPAROTOMY IN NEWLY DIAGNOSED HODGKINS-DISEASE AND NON-HODGKINS LYMPHOMA JOURNAL OF CLINICAL ONCOLOGY Castellino, R. A., Dunnick, N. R., Goffinet, D. R., ROSENBERG, S. R., KAPLAN, H. S. 1983; 1 (9): 532-536

    View details for Web of Science ID A1983RK55800003

    View details for PubMedID 6668514

  • ANALYSIS OF NON-HODGKINS LYMPHOMAS WITH NODULAR AND FAVORABLE HISTOLOGIES, STAGE-I AND STAGE-II CANCER PARYANI, S. B., Hoppe, R. T., Cox, R. S., Colby, T. V., Rosenberg, S. A., KAPLAN, H. S. 1983; 52 (12): 2300-2307

    Abstract

    Between 1961 and 1980, 124 patients with Stages I and II nodular lymphocytic poorly differentiated (NLPD), nodular mixed histiocytic-lymphocytic (NM), nodular histiocytic (NH), or diffuse well-differentiated lymphocytic (DLWD) lymphoma according to the Rappaport classification were treated at Stanford University. Initial staging studies included lymphangiography in 91%, bone marrow biopsy in 93%, and diagnostic or staging laparotomy in 41% of patients. All patients were treated with megavoltage irradiation to either involved field (IF), extended field (EF), or total lymphoid fields (TLI) to a total dose of 3500-5000 rad. Median follow-up was 5.5 years. Kaplan-Meier actuarial survival at 5, 10, and 15 years was 84%, 68%, and 42%, respectively. Freedom from relapse at 5 and 10 years was 62% and 54%, respectively. In addition, there was a flattening of the relapse curve suggesting cure of approximately 50% of patients. Patients with NH had a significantly poorer survival (P = 0.03) while there were no differences among the other histologic groups. Freedom from relapse was higher in patients treated with TLI compared with those treated with IF or EF. However, a prospective study of 20 patients who all underwent staging laparotomy and were randomized to treatment with either IF or TLI revealed no significant difference in either survival or freedom from relapse. Utilizing multivariate analysis for the entire group, important prognostic factors included age, stage, histologic subtype, and treatment field.

    View details for Web of Science ID A1983RT51300023

    View details for PubMedID 6416664

  • HODGKINS-DISEASE LIMITED TO INTRATHORACIC SITES CANCER Johnson, D. W., Hoppe, R. T., Cox, R. S., Rosenberg, S. A., KAPLAN, H. S. 1983; 52 (1): 8-13

    Abstract

    The records of 1470 patients treated for Hodgkin's disease between 1960 and 1980 were reviewed, and sites of initial involvement were scored. Forty-four patients had disease limited to the chest after clinical and/or pathologic staging. Eighteen asymptomatic patients underwent a staging laparotomy and no occult subdiaphragmatic disease was identified. All 44 patients were treated with irradiation (XRT) to involved (IF), mantle (M), subtotal lymphoid (STLI), or total lymphoid (TLI) fields. Eighteen patients were also treated with chemotherapy, consisting of nitrogen mustard, vincristine, and procarbazine, with or without prednisone (MOP(P)), or procarbazine, melphalan, and vinblastine (PAVe). With a median follow-up of 7.5 years the survival at five and ten years was 93% and 89%, respectively, and the freedom from relapse (FFR) at five and ten years was 81% and 78%, respectively. Ten patients relapsed, all in supradiaphragmatic sites (including six relapses within lung parenchyma). Eight had initially received XRT alone, and two had received combined modality treatment. The risk of relapse in the 26 patients treated with XRT alone varied inversely with the volume irradiated: IF, 100% (3/3); M, 45% (3/7); STLI, 17% (2/12); TLI, 0% (0/4) relapsed. Seven of the eight relapsing patients treated with XRT alone were salvaged with subsequent XRT and/or chemotherapy whereas both of the combined modality patients who relapsed, died with progressive disease despite all salvage therapy.

    View details for Web of Science ID A1983QV52700002

    View details for PubMedID 6850546

  • HISTOLOGIC CONVERSION IN THE NON-HODGKINS LYMPHOMAS JOURNAL OF CLINICAL ONCOLOGY Acker, B., Hoppe, R. T., Colby, T. V., Cox, R. S., KAPLAN, H. S., Rosenberg, S. A. 1983; 1 (1): 11-16

    Abstract

    Between July 1, 1971 and December 31, 1978, 150 patients with favorable subtypes of non-Hodgkin's lymphoma [nodular poorly differentiated lymphocytic (NLPD), nodular mixed, or diffuse well differentiated lymphocytic] were entered into prospective randomized clinical trials at Stanford University. Treatments included involved field, total lymphoid, or whole body irradiation, single alkylating agent chemotherapy, combination chemotherapy with cyclophosphamide, vincristine and prednisone (CVP) or with cyclophosphamide, vincristine, procarbazine, and prednisone (C-MOPP), or various combinations of chemotherapy and irradiation. The initial complete response rate (CR) was 79%. Among patients who achieved a CR, 31% later relapsed. There were 78 patients who either failed to achieve a CR or achieved a CR and later relapsed. Histologic conversion (change from initially favorable to an unfavorable subtype of non-Hodgkin's lymphoma) was documented in 22/78 patients (28%). However, the actuarial risk for conversion was actually much greater (60% at 8 yr). The median time to documentation of conversion was 51 mo. The most common type of histologic conversion was from NLPD to diffuse histiocytic lymphoma. Documented histologic conversion was often associated with a more aggressive clinical behavior of the lymphoma, and the median survival after conversion was less than 1 yr. However, those patients who achieved a CR after conversion had a more favorable outcome (actuarial survival 75% at 5 yr). No specific risk factors predictive of histologic conversion could be identified.

    View details for Web of Science ID A1983QW72900003

    View details for PubMedID 6366124

  • EXTRALYMPHATIC INVOLVEMENT IN DIFFUSE NON-HODGKINS LYMPHOMA JOURNAL OF CLINICAL ONCOLOGY Paryani, S., Hoppe, R. T., Burke, J. S., Sneed, P., Dawley, D., Cox, R. S., Rosenberg, S. A., KAPLAN, H. S. 1983; 1 (11): 682-688

    Abstract

    Between 1961 and 1982, 543 patients with diffuse histiocytic, mixed, or undifferentiated lymphoma were treated at Stanford University, Stanford, Calif. Of this group, 281 (52%) had extralymphatic lesions and the 111 patients with stage IE and IIE disease were subjected to analysis. Most patients (94) had diffuse histiocytic lymphoma. Lymphangiography was performed in 77%, bone marrow biopsy in 91%, and diagnostic or staging laparotomy in 52% of the patients. All but five patients were treated with megavoltage irradiation and 35 patients received combination chemotherapy. Median follow-up was 4.0 years. Kaplan-Meier actuarial survival at five and 10 years was 46% and 36%, respectively. Freedom from relapse (FFR) at five years was 49% with no relapses beyond that point. The most common extralymphatic sites were the gastrointestinal tract, the head and neck region, and the lung. Prognosis could not be correlated with the specific sites of involvement. Patients with bulky disease (greater than 10 cm) or more than three sites of involvement had a significantly lower survival and FFR. There was no significant difference in outcome for patients treated with irradiation or combined modality therapy. Most patients (62%) relapsed in distant extralymphatic sites.

    View details for Web of Science ID A1983RQ63300003

    View details for PubMedID 6422003

  • THE MANAGEMENT OF STAGE-I-II HODGKINS-DISEASE WITH IRRADIATION ALONE OR COMBINED MODALITY THERAPY - THE STANFORD EXPERIENCE BLOOD Hoppe, R. T., Coleman, C. N., Cox, R. S., Rosenberg, S. A., KAPLAN, H. S. 1982; 59 (3): 455-465

    Abstract

    At Stanford University, between 1968 and 1978, 230 patients with pathologic stage I--II Hodgkin's disease were treated on prospective clinical trials with either irradiation alone or irradiation followed by 6 cycles of adjuvant combination chemotherapy. The actuarial survival at 10 yr was 84% for patients in either treatment group. Freedom from relapse at 10 yr was 77% among patients treated with irradiation alone and 84% after treatment with combined modality therapy [p(Gehan) = 0.09]. Freedom from second relapse at 10 yr was 89% and 94%, respectively [p(Gehan) = 0.56]. Several prognostic factors were evaluated in order to identify patients at high risk for relapse or with poor ultimate survival after initial treatment with irradiation alone. Systemic symptoms, histologic subtype, age, and limited extranodal involvement (E-lesions) did not affect the prognosis of patients and failed to identify patients whose survival could be improved by the routine use of combined modality therapy. Patients with large mediastinal masses (mediastinal mass ratio greater than or equal to 1/3) had a significantly poorer freedom from relapse when treated with irradiation alone than when treated initially with combined modality therapy [45% versus 81% at 10 yr, p(Gehan) = 0.03). The 10-yr survival of these patients, however, was not significantly different (84% versus 74%). The implications of these observations on the management of patient with early stage Hodgkin's disease are discussed.

    View details for Web of Science ID A1982NF36400001

    View details for PubMedID 7059665

  • PROGNOSTIC FACTORS IN PATHOLOGIC STAGE-III HODGKINS-DISEASE CANCER TREATMENT REPORTS Hoppe, R. T., Cox, R. S., Rosenberg, S. A., KAPLAN, H. S. 1982; 66 (4): 743-749

    View details for Web of Science ID A1982NQ55100017

    View details for PubMedID 7074644

  • NATIONAL-CANCER-INSTITUTE SPONSORED STUDY OF CLASSIFICATIONS OF NON-HODGKINS LYMPHOMAS - SUMMARY AND DESCRIPTION OF A WORKING FORMULATION FOR CLINICAL USAGE CANCER Rosenberg, S. A. 1982; 49 (10): 2112-2135
  • SINGLE AGENT PALLIATIVE CHEMOTHERAPY FOR END-STAGE HODGKINS-DISEASE CANCER Mead, G. M., Harker, W. G., KUSHLAN, P., Rosenberg, S. A. 1982; 50 (5): 829-835

    View details for Web of Science ID A1982PC14300003

    View details for PubMedID 6178495

  • THE RELATIVE CLINICAL-VALUE OF THE VARIOUS CLASSIFICATIONS OF HUMAN NON-HODGKINS LYMPHOMAS UCLA SYMPOSIA ON MOLECULAR AND CELLULAR BIOLOGY Rosenberg, S. A. 1982; 24: 43-50
  • LYMPHOMAS INVOLVING THE GASTROINTESTINAL-TRACT GASTROENTEROLOGY Gray, G. M., Rosenberg, S. A., Cooper, A. D., Gregory, P. B., Stein, D. T., HERZENBERG, H. 1982; 82 (1): 143-152

    View details for Web of Science ID A1982MW05000026

    View details for PubMedID 7053326

  • FEMALE REPRODUCTIVE POTENTIAL AFTER TREATMENT FOR HODGKINS-DISEASE NEW ENGLAND JOURNAL OF MEDICINE Horning, S. J., Hoppe, R. T., KAPLAN, H. S., Rosenberg, S. A. 1981; 304 (23): 1377-1382

    Abstract

    The probability of maintaining ovarian function, becoming pregnant, and delivering a normal child is important to young women anticipating successful therapy for Hodgkin's disease. In this study, reproductive function was retrospectively examined in 103 women 40 years old or younger who had undergone treatment for Hodgkin's disease with total-lymphoid irradiation (TLI) alone, combination chemotherapy, or combined TLI and chemotherapy. Infertility was directly related to gonadal exposure to therapy and to age at treatment. Twenty women became pregnant after receiving total-nodal irradiation or combination chemotherapy or both. No fetal wastage occurred, and no birth defects were seen in the 24 infants born to these women. Even after intensive treatment programs, women successfully treated for Hodgkin's disease have become pregnant and delivered phenotypically normal children.

    View details for Web of Science ID A1981LR62000001

    View details for PubMedID 7231460

  • PROGNOSTIC FACTORS IN PATHOLOGICAL STAGE-IIIA HODGKINS-DISEASE CANCER Hoppe, R. T., Rosenberg, S. A., KAPLAN, H. S., Cox, R. S. 1980; 46 (5): 1240-1246

    Abstract

    From July 1968 through December 1977, 171 previously untreated patients with pathological stage IIIA Hodgkin's disease were evaluated at Stanford University Medical Center. All patients underwent lymphography, staging laparotomy and splenectomy; 86 patients were treated with total lymphoid irradiation (mantle followed by inverted-Y) to 4400 rad. These patients received prophylactic irradiation to the preauricular region (3600 rad/4-5 wk.) if the high cervical lymph nodes were positive; the lung (1500 rad/4-5 wk.) if the ipsilateral pulmonary hilum was positive; and the liver (2200 rad/5-6 wk.) if the spleen was positive. Eighty-five patients were treated with total lymphoid irradiation followed by adjuvant chemotherapy-either nitrogen mustard, vincristine and procarbazine (MOP) or procarbazine, L-phenylalanine mustard, and vinblastine (PAVe). Five-year survival rates were not significantly different in the two groups (86% vs. 89%, P = .4); however, the five-year freedom from relapse rate was significantly better in the combined modality group (66% vs. 86%, P = .0026). Because of the success of MOP in the treatment of patients who had relapses after treatment with irradiation alone, the five-year freedom from second relapse rates in the two groups were not significantly different (85% vs. 88%, P = .8). Analysis of a large number of possible prognostic factors failed to identify any subgroup of patients whose survival was significantly improved by the use of adjuvant chemotherapy, including patients with "anatomic substage III2" (P = .52), clinical stage III (P = .26), unfavorable histology (P = .78), age greater than 39 yr. (P = .44), males (P = .55), and S- (P = .92). The most important factors indicating a benefit from adjuvant chemotherapy on survival were greater than or equal to 5 sites of involvement, including those above and below the diaphragm (P = .15) and extensive splenic involvement (more than four nodules detected in the splenectomy specimen) (P = .15). Possible explanations for these observations, which differ from those of series reported at other institutions, are discussed.

    View details for Web of Science ID A1980KF23500025

    View details for PubMedID 7214305

  • HODGKINS-DISEASE - CURRENT STATUS AND FUTURE CHALLENGES SEMINARS IN ONCOLOGY Rosenberg, S. A. 1980; 7 (2): 212-214

    View details for Web of Science ID A1980JY20800013

    View details for PubMedID 6934622

  • ALTERNATING CHEMOTHERAPY AND IRRADIATION IN THE TREATMENT OF ADVANCED HODGKINS-DISEASE CANCER Hoppe, R. T., Portlock, C. S., Glatstein, E., Rosenberg, S. A., KAPLAN, H. S. 1979; 43 (2): 472-481

    View details for Web of Science ID A1979GK93700010

    View details for PubMedID 369676

  • VALUE OF SEQUENTIAL BONE-MARROW BIOPSY AND LAPAROTOMY AND SPLENECTOMY IN A SERIES OF 200 CONSECUTIVE UNTREATED PATIENTS WITH NON-HODGKINS LYMPHOMA EUROPEAN JOURNAL OF CANCER RIBASMUNDO, M., Rosenberg, S. A. 1979; 15 (7): 941-952

    View details for Web of Science ID A1979HA83100002

    View details for PubMedID 488154

  • NON-HODGKINS LYMPHOMA - SELECTION OF TREATMENT ON THE BASIS OF HISTOLOGIC TYPE NEW ENGLAND JOURNAL OF MEDICINE Rosenberg, S. A. 1979; 301 (17): 924-928
  • PRELIMINARY-OBSERVATIONS ON EFFECT OF HUMAN LEUKOCYTE INTERFERON IN NON-HODGKINS LYMPHOMA NEW ENGLAND JOURNAL OF MEDICINE Merigan, T. C., Sikora, K., BREEDEN, J. H., Levy, R., Rosenberg, S. A. 1978; 299 (26): 1449-1453

    View details for Web of Science ID A1978GC17400008

    View details for PubMedID 362211

  • IMPACT OF SALVAGE TREATMENT ON INITIAL RELAPSES IN PATIENTS WITH HODGKIN DISEASE, STAGES I-III BLOOD Portlock, C. S., Rosenberg, S. A., Glatstein, E., KAPLAN, H. S. 1978; 51 (5): 825-833

    View details for Web of Science ID A1978EZ04900006

    View details for PubMedID 638248

  • OVERVIEW OF NON-HODGKINS LYMPHOMAS CANCER TREATMENT REPORTS DeVita, V. T., Levy, Frei, E., Royston, I., Seligmann, M., Sullivan, P., Bloomfield, C. D., Muggia, F. M., Klein, J., RICK, W., Glatstein, E., Grossman, L., Gibbs, F., Rosenberg, S. A. 1977; 61 (6): 1219-1221
  • VALIDITY OF ANN-ARBOR STAGING CLASSIFICATION FOR NON-HODGKINS LYMPHOMAS CANCER TREATMENT REPORTS Rosenberg, S. A. 1977; 61 (6): 1023-1027

    Abstract

    The Ann Arbor staging classification has proved to be valuable for Hodgkin's disease. When proposed in 1971 it was thought that it could also be applied to the non-Hodgkin's lymphomas. The diversity of the non-Hodgkin's groups, the continued evolution of histopathologic classifications, and the great frequency of advanced disease in the lymphocytic subgroups make the Ann Arbor classification of only limited value for the non-Hodgkin's lymphomas.

    View details for Web of Science ID A1977DX62400012

    View details for PubMedID 902260

  • INITIAL RELAPSE IN PREVIOUSLY TREATED HODGKINS-DISEASE .2. RETROGRADE TRANS-DIAPHRAGMATIC EXTENSION INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS Weller, S. A., Glatstein, E., Castellino, R. A., KAPLAN, H. S., Rosenberg, S. A. 1977; 2 (9-10): 863-872

    View details for Web of Science ID A1977EJ73300004

    View details for PubMedID 591406

  • CHEMOTHERAPY OF NON-HODGKINS LYMPHOMAS - STANFORD EXPERIENCE CANCER TREATMENT REPORTS Portlock, C. S., Rosenberg, S. A. 1977; 61 (6): 1049-1055

    View details for Web of Science ID A1977DX62400014

    View details for PubMedID 332344

  • CHEMOTHERAPY OF NON-HODGKINS LYMPHOMAS CANCER TREATMENT REPORTS Frei, E., ANDERSON, T., Bertino, J. R., Bloomfield, C. D., Richardson, Coltman, C. A., DANSKER, G., Salmon, S. E., Durant, J., Bonadonna, G., COLLANIO, C., Portlock, C. S., Nissen, N. I., Rosenberg, S. A., Justice, G., Rosen, P., Johnston 1977; 61 (6): 1125-1127
  • VALUE OF SEQUENTIAL BONE-MARROW BIOPSY AND LAPAROTOMY AND SPLENECTOMY IN A SERIES OF 127 CONSECUTIVE UNTREATED PATIENTS WITH NON-HODGKINS LYMPHOMA BRITISH JOURNAL OF CANCER Rosenberg, S. A., Dorfman, R. F., KAPLAN, H. S. 1975; 31: 221-227
  • BONE-MARROW INVOLVEMENT IN NON-HODGKINS LYMPHOMATA BRITISH JOURNAL OF CANCER Rosenberg, S. A. 1975; 31: 261-264
  • CLINICAL TRIALS IN NON-HODGKINS LYMPHOMATA AT STANFORD-UNIVERSITY EXPERIMENTAL DESIGN AND PRELIMINARY RESULTS BRITISH JOURNAL OF CANCER Rosenberg, S. A., KAPLAN, H. S. 1975; 31: 456-464
  • SUMMARY OF RESULTS OF A REVIEW OF 405 PATIENTS WITH NON-HODGKINS LYMPHOMA AT STANFORD-UNIVERSITY BRITISH JOURNAL OF CANCER Rosenberg, S. A., Dorfman, R. F., KAPLAN, H. S. 1975; 31: 168-173
  • MANAGEMENT OF HODGKINS-DISEASE CANCER KAPLAN, H. S., Rosenberg, S. A. 1975; 36 (2): 796-803

    Abstract

    This paper presents a destillation of the authors' current views concerning the optimal management of Hodgkin's disease in relation to site(s) and stage of disease, constitutional symptoms, histopathology, and prior treatment, based on experience with a series of controlled clinical trials under way at Stanford University Medical Center since 1962.

    View details for Web of Science ID A1975AQ22900024

    View details for PubMedID 1157037

  • COMBINATION CHEMOTHERAPY IN HODGKINS-DISEASE - RELATION TO RADIOTHERAPY BIBLIOTHECA HAEMATOLOGICA Rosenberg, S. A. 1973: 731-735

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