Rubio R
Unidad Infeccion HIV, Hospital 12 de Octubre, Madrid, Spain.
Cancer. 1994 May 1;73(9):2400-7. doi: 10.1002/1097-0142(19940501)73:9<2400::aid-cncr2820730925>3.0.co;2-c.
Hogdkin's disease is not an acquired immunodeficiency syndrome (AIDS)-defining illness. However, Hodgkin's disease associated with human immunodeficiency virus (HIV) infection has a different natural history and therapeutic outcome than in the general population of Hodgkin's disease patients.
The authors studied the epidemiologic and clinicopathologic features and therapeutic outcomes of 46 patients with Hodgkin's disease associated with HIV infection collected from a cooperative study of nine hospitals in Madrid, Spain.
Forty-three (93.5%) of the subjects were men and three (6.5%) were women, with a mean age of 26.9 years. Thirty-nine (84.8%) were intravenous drug users and four (8.7%) were homosexuals. In 43 patients (93.5%), Hodgkin's disease was the first manifestation of HIV infection. In 16 patients (34.8%), AIDS developed after the diagnosis of Hodgkin's disease. Histologic subtypes were mixed cellularity (41.3%), lymphoid depletion (21.7%), nodular sclerosis (21.7%), and lymphocytic predominance (4.3%). At diagnosis, 89.1% had advanced stages (III,IV), 82.6% had B symptoms, and 41.3% had bone marrow involvement. Of 27 evaluable patients treated with chemotherapy, 44.4% had a complete response (16.7% relapsed) and 37% had a partial response. Median survival was 15 months (range, 1-44 months). Projected 3-year survival rate was 19%, and projected event-free survival rate was 22% at 30 months. Adverse prognostic factors for survival in univariate analysis were B symptoms, no response to chemotherapy, hemoglobin levels less than 11 g/dl, leukocyte count less than 4500/mm3, total lymphocyte count less than 1000/mm3, CD4 lymphocyte count less than 200/mm3, and alkaline phosphatase level greater than 300 IU/l.
Hodgkin's disease associated with HIV infection is more frequent among intravenous drug addicts, and the clinical course is different in these patients from that in the general population of Hodgkin's disease patients, showing high frequency of advanced stages, unfavorable histologic subtypes, poor therapeutic response, and short survival time.
霍奇金淋巴瘤并非获得性免疫缺陷综合征（AIDS）的定义性疾病。然而，与人类免疫缺陷病毒（HIV）感染相关的霍奇金淋巴瘤与一般霍奇金淋巴瘤患者群体相比，具有不同的自然病程和治疗结果。
作者研究了从西班牙马德里九家医院的一项合作研究中收集的46例与HIV感染相关的霍奇金淋巴瘤患者的流行病学、临床病理特征及治疗结果。
受试者中43例（93.5%）为男性，3例（6.5%）为女性，平均年龄26.9岁。39例（84.8%）为静脉吸毒者，4例（8.7%）为同性恋者。43例患者（93.5%）中，霍奇金淋巴瘤是HIV感染的首发表现。16例患者（34.8%）在霍奇金淋巴瘤诊断后发展为AIDS。组织学亚型为混合细胞型（41.3%）、淋巴细胞消减型（21.7%）、结节硬化型（21.7%）和淋巴细胞为主型（4.3%）。诊断时，89.1%处于晚期（III、IV期），82.6%有B症状，41.3%有骨髓受累。在27例接受化疗的可评估患者中，44.4%获得完全缓解（16.7%复发），37%获得部分缓解。中位生存期为15个月（范围1 - 44个月）。预计3年生存率为19%，预计30个月无事件生存率为22%。单因素分析中，生存的不良预后因素为B症状、对化疗无反应、血红蛋白水平低于11 g/dl、白细胞计数低于4500/mm³、总淋巴细胞计数低于1000/mm³、CD4淋巴细胞计数低于200/mm³以及碱性磷酸酶水平高于300 IU/l。
与HIV感染相关的霍奇金淋巴瘤在静脉吸毒者中更为常见，这些患者的临床病程与一般霍奇金淋巴瘤患者群体不同，表现为晚期频率高、组织学亚型不良、治疗反应差及生存时间短。
