title: Hodgkin's Disease in 50 Intravenous Drug Users with HIV-Infection.
abstract: Fifty cases of Hodgkin's disease in intravenous drug users (IVDU) have been collected by the Italian Cooperative Group on AIDS-Related Tumors (G.I.C.A.T.). Ninety-two per cent of the patients were males; the median age was 26 years. Persistent generalized lymphadenopathy (PGL) at onset was present in 54% of patients, AIDS in 9%, ARC in 9% while 28% were simply HIV-positive. The initial median absolute number of CD4 lymphocytes was 264/mmc. Opportunistic infections were diagnosed in 20% of patients. In most patients the histological pattern was that of mixed cellularity and lymphocytic depletion (76%). In almost half the initial symptom was a persistent lymph node enlargement due to PGL. In the majority of patients (58%) only a clinical staging and bone marrow biopsy could be performed due to the presence of opportunistic infections, rapid disease progression or refusal of pathologic staging procedures. One patient presented with a Waldeyer's ring involvement, but no other unusual presentations were observed. After MOPP alternated or followed by ABVD or MOPP alone, 15/29 CR (52%) and 14/29 PR (48%) were observed. The median duration of CR was 14 months, while the median survival of CR has not been reached; the median survival of patients treated with chemotherapy with CD4 values at presentation {geq}400/mmc was significantly superior to that in those with CD4 < 400/mmc. The overall median survival was 16 months. Twenty-eight per cent of patients receiving chemotherapy + radiotherapy developed opportunistic as well as non-opportunistic infections (21%). Lethal hepatic toxicity was observed in 2 patients. In conclusion, Hodgkin's disease in IVDU was not found to be associated with unusual presentations, as previously reported for homosexuals. Complete remissions could be achieved in over 50% of patients, but in IVDU non-opportunistic infections in addition to opportunistic infections may also limit treatment administration. The presence of parenchymal functional impairment due to drug abuse, or drug abuse-related infections, such as pneumonia, endocarditis and hepatitis, should lead to the choice of antitumour agents with no or only minor potential liver, lung and cardiac toxicity.
authors.affiliation: a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Monfardini
authors.affiliation: a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Tirelli
authors.affiliation: a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vaccher
authors.affiliation: a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Errante
authors.affiliation: a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rezza
authors.affiliation: a Centro di Riferimento Oncologico, Via Pedemontana Occ., 33081, Aviano, PN, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Talamint
authors.affiliation: b Ospedale Civile di Piacenza, Divisione Malattie Infettive, 29100, Piacenza, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Albericci
authors.affiliation: c Ospedale Civile di Bergamo, Divisione di Ematologia, 24100, Bergamo, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Barbui
authors.affiliation: d Policlinico S. Matteo, Divisione di Ematologia, Via Mentana 4, 27100, Pavia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bernasconi
authors.affiliation: e Istituto di Clinica Meica 111, Divisione di Malattie Cardiovascolari, Via del Vespro 127, Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cajozzo
authors.affiliation: f Ospedale L. Sacco, Divisione Malattie Infettive, Via G. B. Grassi 74, 20157, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cargnel
authors.affiliation: g Ospedale S. Carlo Borromeo, Divisione Oncologia Medica, Via Pio 111 n.3, Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Clerici
authors.affiliation: h Ospedale Generale Provinciale S. Anna, Divisione Malattie Infettive, Via Napoleone 60, Como, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Lalla
authors.affiliation: i Ospedale A. Businico, Divisione di Ematologia, Via Jenner, Cagliari, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Dessalvi
authors.affiliation: j Universita degli Studi di Parma, Cattedra di Malattie Infettive, Via Gramsci 14, Parma, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Fiaccadori
authors.affiliation: k Ospedale Civile di Alessandria USL 70, Divisione di Malattie Infettive, Via Comunale 33, Valmadonna, AL, Italy.
authors.forename: P L
authors.initials: PL
authors.lastname: Garavelli
authors.affiliation: l Arcispedale, S. Maria Nuova, Divisione Malattie Infettive, Via Risorgimento, Reggio Emilia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Giudici
authors.affiliation: m Policlinico S. Orsola, lnstituto di Ematologia, Via G. Massarenti 9, Bologna, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Gherlinzoni
authors.affiliation: n Ospedale Maggiore Milano, lnstituo di Scienze Mediche, Via F. Sforza 35, Milano, Italy.
authors.forename: G L
authors.initials: GL
authors.lastname: Deliliers
authors.affiliation: f Ospedale L. Sacco, Divisione Malattie Infettive, Via G. B. Grassi 74, 20157, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lazzarin
authors.affiliation: o Cattedra di Allergologia ed Immunologia, Universita La Sapienza, Pol. Umberto, Viale Universita 37, Roma, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Luzi
authors.affiliation: p Ospedale B. Trento, Divisione Malattie Infettive, Verona, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Luzzati
authors.affiliation: q lnstituto IRCCS, Divisione Malattie Infettive, Piazzale Golgi, 27100, Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Malfitano
authors.affiliation: r Cattedra di Ematologia, Dipartimento di Biopatologia Umana, Via Benevento 6,00161, Roma, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
authors.affiliation: s Ospedale S. Andrea, Via Veneto 197, Divisione Malattie Infettive, Via Veneto 197, 19100, La Spezia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Marigo
authors.affiliation: t Cattedra di Oncologia Medica, Universita degli Studi di Napoli, Via Sergio Pansini 5, 80131, Napoli, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Montesarchio
authors.affiliation: f Ospedale L. Sacco, Divisione Malattie Infettive, Via G. B. Grassi 74, 20157, Milano, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Moroni
authors.affiliation: u Instituto Scientific0 di Medicina Interna, Universita degli Studi di Genova, Viale Benedetto XV 6, 16132, Genova, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Puppo
authors.affiliation: v Ospedale Maggiore di Bologna, Divisione Malattie Infettive ed Immunopatologia., Via L. B. Nigrisoli 2, 40133, Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Raise
authors.affiliation: f Ospedale L. Sacco, Divisione Malattie Infettive, Via G. B. Grassi 74, 20157, Milano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rizzardini
authors.affiliation: w Ospedali Riuniti, Divisione Malattie Infettive, Largo Barozzi 11, 24100, Bergamo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rizzi
authors.affiliation: x Ospedali Civili di Brescia, Ill Medicina Sezione Ematologia, 25125, Brescia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Rossi
authors.affiliation: y Ospedale S. Andrea, Divisione Malattie Infettive, C. so M. Abbiate 31, 13100, Vercelli, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Saliva
authors.affiliation: z Ospedale Fatebenefratelli e Oftalmico, Corso di Porta Nuova 23, 20121, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Scanni
authors.affiliation: aa Universita di Torino-Ospedale Amedeo di Savoia, Divisione Malattie Infettive, Corso Svizzera 164, 10149, Torino, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sinicco
authors.affiliation: ab Ospedale Civile di Vicenza, Viale F. Rodolfi, 36100, Vicenza, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Vaglia
authors.affiliation: ac Universita di Torino, Dipartimento di Scienzo Biomediche, Clinica Medica A, Via Genova 3, 10126, Torino, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Foà
authors.affiliation: ac Universita di Torino, Dipartimento di Scienzo Biomediche, Clinica Medica A, Via Genova 3, 10126, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Gavosto
keywords: HIV infection; Hodgkin's discase; intravenous drug users