Atypical presentation of Hodgkin's disease in a patient at risk for the acquired immunodeficiency syndrome.
Hodgkin's disease (HD) has been reported in association with the acquired immunodeficiency syndrome (AIDS) only occasionally, and these patients seemed to have aggressive unusual HD. We report an additional case of HD in a 50-year-old homosexual man with a marked change of his clinical course after the development of seropositivity to human immunodeficiency virus (HIV). In 1978, HD stage IIIA, nodular sclerosing type, was diagnosed and treated with splenectomy and total nodal radiotherapy, which led to a complete response lasting till 1985. The patient then reported to our clinic with generalized lymphadenopathy and paresis of the m. biceps and m. triceps due to an infiltration of C6/C7 by HD. Laboratory findings revealed a T4/T8 ratio of 0.5 and HIV antibodies. He was given chemotherapy (COPP), but after a good initial response he developed pulmonary infiltration of HD. Therapy was changed to ABVD, but the patient did not respond to treatment and died of progressive HD in 1986. We therefore conclude that the natural history of HD in patients at risk for AIDS may be altered to a higher malignant form, and treatment modalities used in these patients must be further evaluated.
Keyserlingk
H
H
Department of Hematology and Oncology, University Medical Center Steglitz, Free University of Berlin, West Berlin, Federal Republic of Germany.
Ludwig
W D
WD
Seibt
H
H
Rühl
H
H
Höffken
G
G
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage; D006679:HIV Seropositivity; D006689:Hodgkin Disease / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D012307:Risk Factors; D014750:Vincristine / Q000008:administration & dosage
D011344:Procarbazine; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone