HUMAN-IMMUNODEFICIENCY-VIRUS ASSOCIATED HODGKINS-DISEASE - REPORT OF 45 CASES FROM THE FRENCH REGISTRY OF HIV-ASSOCIATED TUMORS
HUMAN-IMMUNODEFICIENCY-VIRUS ASSOCIATED HODGKINS-DISEASE - REPORT OF 45 CASES FROM THE FRENCH REGISTRY OF HIV-ASSOCIATED TUMORS
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DOI：
10.3109/10428199509054433
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发表时间：
1995-02-01
影响因子：
2.6
通讯作者：
ANDRIEU, JM
中科院分区：
文献类型：
--
作者：
LEVY, R;COLONNA, P;ANDRIEU, JM
本文分析了1987年1月至1989年12月由法国HIV相关肿瘤登记处收集的45例霍奇金病(HD)患者的临床病理特征和转归，并与1981年9月至1988年8月参加多中心临床试验的407例临床分期(CS)IA~IVB的患者进行了比较。研究人员记录了HIV感染途径、HD诊断时的初始CD4细胞计数以及HIV感染的CDC分级。HIV-HD的特点是以晚期CS(75%)、B症状(80%)和混合细胞组织学(49%)为主，并有早期骨髓受累(24%)；一个特殊的特征是罕见的纵隔受累(HIV-HD为13%，而初级HD为71%)。在标准治疗下，79%的患者完全缓解，但血液学和感染性并发症非常常见。静脉吸毒者(IVDA)在HIV-HD中的比例(38%)高于法国HIV感染人群的整体比例(20.8%)。L确诊时CD_4细胞计数中位数为306个/亩，而只有5例(11%)患者在确诊前有艾滋病症状，2年后进展为艾滋病的比率为94%。总的2年生存率为41%，其中初始CD_4细胞数高于300U/亩的患者为71%，CD_4细胞数低于300U的患者为0%(P&T；0.01)；机会感染是最常见的死亡原因。HIV-HD似乎优先发生在。IVDA：与原发HD相比具有特殊的特点，以混合细胞型为主，晚期CS发生率高，无纵隔受累的患者比例高。标准的HD疗法似乎对这类患者有效，但毒性过大。
Clinical and pathological characteristics as well as outcome of 45 Hodgkin's disease (HD) cases collected by the French registry of HIV-associated tumors between January 1987 and December 1989 (all clinically staged according to the Ann Arbor system) were analyzed and compared with those of a cohort of 407 patients with clinical stages (CS) IA to IVB enrolled between September 1981 and August 1988 in a multicentric clinical trial. The route of HIV infection, initial CD4 cell count at the time of HD diagnosis and CDC class of HIV infection were studied as well as the progression to AIDS onset were recorded.HIV-HD is characterized by a predominance of advanced CS (75%), B symptoms (80%) and mixed cellularity histology (49%), as well as by early bone marrow involvement (24%); a specific feature is the rare occurrence of mediastinal involvement (13% in HIV-HD versus 71% in primary HD). With standard therapies, 79% of the patients achieved a complete remission, but hematological and infectious complications were very frequent. The proportion of intravenous drug abusers (IVDA) in HIV-HD (38%) is higher than in French HIV-infected population as a whole (20.8%). Median CD4 cell count was 306/mu l at the time of HD diagnosis, while only 5 cases (11%) were preceded by an AIDS manifestation; progression to AIDS rate was 94% at 2 years. Overall 2-year survival was 41%, with 71% for patients with an initial CD4 cell count over 300/mu l and 0% for those with CD4 cell count lower than 300/mu l (p < 0.01); opportunistic infections were the most frequent cause of death.HIV-HD seems to occur preferentially in. IVDA; it has a particular profile when compared to primary HD, with a predominance of mixed cellularity type, a high frequency of advanced CS, and a high proportion of patients without mediastinal involvement. Standard HD therapy seems to be efficient but excessively toxic in this group of patients.