Errante D, Zagonel V, Vaccher E, Serraino D, Bernardi D, Sorio R, Trovò M, Carbone A, Monfardini S, Tirelli U
Division of Medical Oncology and AIDS, Centro di Riferimento Oncologico, Aviano, Italy.
Ann Oncol. 1994;5 Suppl 2:37-40. doi: 10.1093/annonc/5.suppl_2.s37.
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.
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.
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).
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.
霍奇金淋巴瘤（HD）在合并不良预后因素的HIV感染患者中已有报道。同样，老年普通人群中的HD预后较年轻患者差。
为比较HIV感染患者与普通人群中HD的临床病理特征及生存率，我们分析了1986年至1992年间的176例HD患者。我们将84例HIV阴性患者分为两组：A组包括年龄小于55岁的患者，B组包括55岁及以上的患者。进行这种分组是为了将HIV感染患者中的HD与普通人群中预后较差的HD患者组（即老年患者）进行比较。
与较年轻组（85%）相比，老年组患者和HIV感染患者的结节硬化亚型频率显著较低（分别为31%和21%）。混合细胞型（MC）在老年组患者和HIV感染患者中均显著更常见。老年患者中淋巴细胞为主型更常见（16%），高于其他两组。HIV感染患者更易出现晚期、B症状和结外受累。单纯化疗（CT）是HIV感染患者中使用最广泛的治疗方法（83%），而CT加放疗（RT）主要用于普通人群。12例（14%）HIV感染患者未接受任何治疗。HIV感染患者中51%的病例实现了完全缓解，普通人群中约90%的病例实现了完全缓解。HIV感染患者的估计4年生存率远低于其他两组（A组为100%，B组为88%，HIV感染患者为33%）。
虽然MC是HIV感染患者和老年普通人群中最常见的组织学亚型，但HIV感染患者中的HD预后比老年普通人群更差，这不仅是因为潜在的HIV感染，还因为初诊时更不利的临床病理特征。
