Levine A M
Division of Hematology, University of Southern California School of Medicine, Los Angeles, USA.
Hematol Oncol Clin North Am. 1996 Oct;10(5):1135-48. doi: 10.1016/s0889-8588(05)70389-0.
The incidence of HD appears to have increased in HIV-infected individuals, with HIV-seropositive intravenous drug users most likely to develop the disorder. All groups at risk for HIV, however, may develop HD. The pathologic spectrum of HD in the setting of HIV infection is distinct from that seen in "de novo" HD in the United States, with the majority of patients diagnosed with the mixed cellularity subtype, as opposed to the more usual occurrence of nodular sclerosis in "de novo" disease. The presence of fibrohistiocytic stromal cells within involved tissues is also a distinct characteristic of HIV-associated HD. Epstein-Barr viral genome has been detected within tumor cell nuclei, and it may be involved in the pathogenesis of disease. Clinically, patients often present with systemic "B" symptoms and widely disseminated extranodal disease, seen in 75% to 90%. Bone marrow is involved in 40% to 50% of cases at diagnosis. Complete remission may be achieved in approximately 50% of patients after use of combination chemotherapy, but median survival is short, in the range of 12 to 18 months. Death is often due to bacterial or opportunistic infection (or both), often occurring in the setting of chemotherapy-induced neutropenia.
在HIV感染个体中，霍奇金淋巴瘤（HD）的发病率似乎有所增加，HIV血清反应阳性的静脉注射吸毒者最易患此病。然而，所有有感染HIV风险的人群都可能患HD。HIV感染情况下HD的病理谱与美国“原发性”HD不同，大多数患者被诊断为混合细胞型亚型，而不是“原发性”疾病中更常见的结节硬化型。受累组织中存在纤维组织细胞性基质细胞也是HIV相关HD的一个显著特征。在肿瘤细胞核内已检测到爱泼斯坦 - 巴尔病毒基因组，它可能参与了疾病的发病机制。临床上，患者常出现全身“B”症状和广泛播散的结外疾病，75%至90%的患者会出现这种情况。诊断时40%至50%的病例骨髓受累。联合化疗后约50%的患者可实现完全缓解，但中位生存期较短，在12至18个月范围内。死亡通常是由于细菌感染或机会性感染（或两者兼有），常在化疗引起的中性粒细胞减少的情况下发生。
