Hodgkin's disease in patients with antibodies to human immunodeficiency virus. A study of 22 patients.
The experience of 22 Hodgkin's disease (HD) patients with human immunodeficiency virus type I (HIV) antibodies, collected from a cooperative study of six hospitals during 1984-1989 is presented. Young men (average age, 27.6 years) with a high incidence of intravenous drug abuse (86%) were found. The status of the HIV infection at diagnosis of HD was: four patients, acquired immune deficiency syndrome (AIDS); eight patients, persistent generalized lymphadenopathy (PGL); and ten patients, asymptomatic. The natural history of HD was unusual, with a high incidence of B symptoms (81%), advanced Stages III to IV (90%), bone marrow invasion (50%), cytopenias before treatment (45%), opportunistic infections (68%), and aggressive histologies. A decreased response to chemotherapy with poor marrow tolerance and a significant decrease in survival, 18 months, was observed. The AIDS and cytopenias pretreatment were associated with a shorter statistically significant survival, which defines the importance of immunodeficiency in HD prognosis. Complete remission after treatment was a factor that contributed to a longer statistically significant survival. The PGL or asymptomatic patients survived longer but also had a poor course, and five of them had AIDS criteria during evolution. A high incidence of HD in relation to non-Hodgkin's lymphoma (NHL) in patients with HIV infection in the six cooperating hospitals was found. Criteria for considering HD as an AIDS-associated lymphoproliferative disease in our environment are discussed.
Serrano
M
M
Hospital Ramón y Cajal, Alcalá de Henares University, Madrid, Spain.
Bellas
C
C
Campo
E
E
Ribera
J
J
Martín
C
C
Rubio
R
R
Ruiz
C
C
Ocaña
I
I
Buzón
L
L
Yebra
M
M
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000401:mortality; D000328:Adult; D003131:Combined Modality Therapy; D015658:HIV Infections / Q000150:complications* / Q000401:mortality; D006689:Hodgkin Disease / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008228:Lymphoma, Non-Hodgkin / Q000150:complications; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009894:Opportunistic Infections / Q000453:epidemiology / Q000401:mortality; D012074:Remission Induction; D015996:Survival Rate