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Document 3006
DOCN M94A3006
TI Hodgkin's disease and HIV infection (HD-HIV) in 114 patients (pts).
GICAT.
DT 9412
AU Errante D; Serraino D; Franceschi S; Nasti G; Bernardi D; Boiocchi M;
Carbone A; Tirelli U; Rossi G; Ridolfo A; Division of Medical Oncology
and AIDS, Centro di Riferimento; Oncologico, Aviano, Italy.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):175 (abstract no. PB0126). Unique
Identifier : AIDSLINE ICA10/94369569
AB OBJECTIVE: To evaluate the epidemiological, virological, pathological
and clinical features of HD-HIV in 144 pts of the GICAT. METHODS: Since
November 1986, 114 cases (103 m, 11 f) of HD-HIV have been collected by
the GICAT. A 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 was made. RESULTS: 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%, mixed cellularity (MC) in 44% and
lymphocyte depletion (LD) in 21% of pts. A 4-fold higher frequency of
the MC and an approximately 12-fold higher frequency of the LD subtypes
were detected among pts with HD-HIV in comparison with the Italian HD
pts not infected with HIV. 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 < 0.001) indicating that EBV may be more
pathogenetically involved in HD-HIV, as previously reported for
HIV-associated NHLs. Thirty-one/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. 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 months. Pts with CD4+ lymphocytes < or = 250/mm3 at onset of HD had
a median survival of 11.5 months, while those with CD4+ > 250/mm3 a
median of 38 months (p = 0.002). The median survival of pts without and
with AIDS at onset of HD was 27 months and 9 months respectively (p <
0.001) and for pts achieving or not CR was 58 months and 11 months
respectively (p < 0.001). The median survival of 26 pts treated with EBV
+/- P + AZT +/- G-CFS was not different (13 months) from that of pts
treated with standard CT (17 months) 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. DISCUSSION AND
CONCLUSIONS. 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 of
antiretroviral therapy and CT with a significant reduction of OI.
DE Adult Causality Comorbidity Cross-Sectional Studies Female
Hodgkin's Disease/*COMPLICATIONS/EPIDEMIOLOGY/PATHOLOGY Human HIV
Infections/*COMPLICATIONS/EPIDEMIOLOGY/PATHOLOGY Incidence
Italy/EPIDEMIOLOGY Lymph Nodes/PATHOLOGY Male Middle Age Neoplasm
Staging Support, Non-U.S. Gov't MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).