title: Hodgkin's disease in patients with HIV infection and in the general population: comparison of clinicopathological features and survival.
abstract: BACKGROUND
  Hodgkin's disease (HD) has been described in patients with HIV infection in association with unfavourable prognostic factors. Similarly, HD in the older general population has a poorer prognosis than in younger patients.
  
  
  METHODS
  With the aim of comparing the clinicopathological features and survival of HD in HIV-infected patients and in the general population, we analysed 176 patients with HD from 1986 to 1992. We divided the 84 HIV-negative patients into two groups: group A included patients less than 55 years old, group B patients of 55 years or older. This division was made in order to compare HD in HIV-infected patients with the less favourable group of patients with HD in the general population, i.e., older patients.
  
  
  RESULTS
  Patients of the older group and HIV-infected patients had a significantly lower frequency (31% and 21%, respectively) of nodular sclerosis subtype compared to the younger group (85%). Mixed cellularity (MC) is significantly more frequent both in the older group and in HIV-infected patients. Lymphocyte predominance is more frequent (16%) in older patients than in the other two groups. HIV-infected patients are more likely to show advanced stages, B symptoms, and extranodal involvement. Chemotherapy (CT) alone has been the most widely used (83%) treatment in HIV-infected patients, while CT plus radiotherapy (RT) has been mostly employed in the general population. Twelve (14%) HIV-infected patients did not receive any treatment. Complete remission was achieved in 51% of the cases in the HIV-infected patients, and around 90% of the cases in the general population. The estimated 4-year survival rate in the HIV-infected patients is much lower (33%) than in the other two groups (100% in group A, and 88% in group B).
  
  
  CONCLUSIONS
  While MC is the most common histological subtype both in HIV-infected patients and in the older general population, HD in HIV-infected patients has a worse prognosis than in the older general population, not only because of underlying HIV infection, but also because of the more unfavourable clinicopathological features at presentation.
authors.affiliation: Division of Medical Oncology and AIDS, Centro di Riferimento Oncologico, Aviano, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Errante
authors.forename: V
authors.initials: V
authors.lastname: Zagonel
authors.forename: E
authors.initials: E
authors.lastname: Vaccher
authors.forename: D
authors.initials: D
authors.lastname: Serraino
authors.forename: D
authors.initials: D
authors.lastname: Bernardi
authors.forename: R
authors.initials: R
authors.lastname: Sorio
authors.forename: M
authors.initials: M
authors.lastname: Trovò
authors.forename: A
authors.initials: A
authors.lastname: Carbone
authors.forename: S
authors.initials: S
authors.lastname: Monfardini
authors.forename: U
authors.initials: U
authors.lastname: Tirelli
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006689:Hodgkin Disease / Q000150:complications / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000706:statistics & numerical data; D012074:Remission Induction; D015996:Survival Rate