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1994-08-09
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Document 1088
DOCN M9471088
TI Epidemiological, virological and clinicopathological data from 114
patients (pts) with Hodgkin's disease and HIV infection (HD-HIV)
evidence of significant relation to Epstein-Barr virus (EBV), increase
of mixed cellularity (MC) and lymphocyte depletion (LD) subtypes and
feasibility of combined treatment with chemotherapy (CT) and zidovudine
(AZT) (Meeting abstract).
DT 9409
AU Errante D; Tirelli U; Serraino D; Boiocchi M; Carbone A; Italian
Cooperative Study Group on AIDS and Tumors (GICAT),; C.R.O. Aviano,
Italy
SO Proc Annu Meet Am Soc Clin Oncol; 13:A22 1994. Unique Identifier :
AIDSLINE ICDB/94600019
AB Since November 1986, 114 cases (103 m, 11 f) of HD-HIV have been
collected by the GICAT. The median age was 29 years (19-57), 80% were
IVDU in accordance to the overall epidemiology of HIV infection in
Italy. At the diagnosis of HD, 17% of pts had AIDS, 22% ARC, 29% PGL and
34% were asymptomatic; median CD4+ cell count was 275/mm3 (9-1100).
Lymphocyte predominance (LP) was observed in 4%, nodular sclerosis (NS)
in 30%, MC in 44% and LD in 21% of pts. In comparison with 125 Italian
HD pts not infected with HIV, observed in the same period of time at our
Institution and with a comparable median age, a 4-fold higher frequency
of the MC and an approx 12-fold higher frequency of the LD subtypes were
detected among pts with HD-HIV. To determine whether EBV may play a role
in HD-HIV we characterized EBV (latent membrane protein, LMP-1) in HD
samples from 18 pts with HD-HIV as well as from a control population of
104 pts with HD. EBV was detected in 14/18 (78%) HD samples from the
former group, but only in 27/104 (25%) HD samples from the latter group
(p less than 0.001) indicating that EBV may be more pathogenetically
involved in HD-HIV, as previously reported for HIV-associated NHLs.
31/108 (28%) and 56/108 (51%) pts were Stage III and IV respectively;
78% of pts had B symptoms. These figures were significantly different
from those observed in pts with HD of the general population. Twelve pts
received no treatment, 7 pts radiotherapy (RT) alone, 53 pts were
treated with standard CT (MOPP, MOPP-/ ABVD +/- RT) and obtained 45%
complete remission (CR) and 34% partial remission (PR). Twenty-six pts
were treated prospectively with EBV +/- P (epirubicin, bleomycin,
vinblastine +/- prednisone) + AZT +/- G-CSF and obtained 58% CR and 27%
PR. The median survival of all pts was 15.3 mo. Pts with CD4+
lymphocytes less than or equal to 250/mm3 at onset of HD had a median
survival or 11.5 months, while those with CD4+ greater than 250/mm3 a
median of 38 mo (p = 0.002). The median survival of pts without and with
Aids at onset of HD was 27 mo and 9 mo, respectively, (p less than
0.001) and for pts achieving or not CR was 11 mo and 58 mo,
respectively, (p less than 0.001). Pts without B symptoms survived
significantly longer than pts with B symptoms (43 vs 12 mo, p less than
0.001). Age more or less than 30 yr, sex, risk group (IVDU vs other
groups), stage (I + II vs III + IV), extranodal involvement, were not
factors influencing survival. The median survival of 26 pts treated with
EBV +/- P + AZT +/- G-CSF was not different (13 mo) from that of pts
treated with standard CT (17 mo) but a statistically significant lower
rate of opportunistic infections (OI) occurred in the first group (32%
vs 74%, p = 0.003) during or after treatment. In conclusion, in
comparison to HIV-negative HD there is evidence of a significant
increase of: (1) MC and LD subtypes, (2) EBV expression in tumor tissue.
Moreover, there is evidence of feasibility or antiretroviral therapy and
CT with a significant reduction of OI.
DE Adult Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE
Female Follow-Up Studies HIV Infections/*DRUG
THERAPY/MORTALITY/PATHOLOGY Herpesviridae Infections/*DRUG
THERAPY/MORTALITY/PATHOLOGY *Herpesvirus 4, Human Hodgkin's
Disease/*DRUG THERAPY/MORTALITY/PATHOLOGY Human Italy/EPIDEMIOLOGY
Leukocyte Count/DRUG EFFECTS Lymphoma, AIDS-Related/*DRUG
THERAPY/MORTALITY/PATHOLOGY Male Neoplasm Staging Survival Rate
Tumor Virus Infections/*DRUG THERAPY/MORTALITY/PATHOLOGY
Zidovudine/ADVERSE EFFECTS/*THERAPEUTIC USE MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).