Annals of Oncology 5:S37-S40, 1994
© 1994 European Society for Medical Oncology
Hodgkin's disease in patients with HIV infection and in the general population: Comparison of clinicopathological features and survival*
1 Division of Medical Oncology and AIDS Aviano, Italy
2 Division of Medical Oncology Aviano, Italy
3 Epidemiology Unit Aviano, Italy
4 Division of Radiotherapy Aviano, Italy
5 Division of Pathology, Centro di Riferimento Oncologico Aviano, Italy
Correspondence to: Umberto Tirelli, Division of Medical Oncology and AIDS Centro di Riferimento Oncologico, 33081 Aviano, Italys
Background: Hodgkin's disease (HD) has been described in patients with HTV infection in association with unfavourable prognostic factors. Similarly, HD in the older general population has a poorer prognosis than in younger patients.
Patients and methods: With the aim of comparing the clinicopathological features and survival of HD in HIV-in-fected patients and in the general population, we analysed 176 patients with HD from 1986 to 1992. We divided the 84 HTV-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.
Results: 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 HTV-infected patients, while CT plus radiotherapy (RT) has been mostly employed in the general population. Twelve (14%) HTV-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).
Conclusion: 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.
age, general population, HIV infection, Hodgkin's disease
* Supported in part by grants of AIRC '91 and grants of the V AIDS Project ISS '92.
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