Document 1088
 DOCN  M9471088
 TI    Epidemiological, virological and clinicopathological data from 114
       patients (pts) with Hodgkin's disease and HIV infection (HD-HIV)
       evidence of significant relation to Epstein-Barr virus (EBV), increase
       of mixed cellularity (MC) and lymphocyte depletion (LD) subtypes and
       feasibility of combined treatment with chemotherapy (CT) and zidovudine
       (AZT) (Meeting abstract).
 DT    9409
 AU    Errante D; Tirelli U; Serraino D; Boiocchi M; Carbone A; Italian
       Cooperative Study Group on AIDS and Tumors (GICAT),; C.R.O. Aviano,
       Italy
 SO    Proc Annu Meet Am Soc Clin Oncol; 13:A22 1994. Unique Identifier :
       AIDSLINE ICDB/94600019
 AB    Since November 1986, 114 cases (103 m, 11 f) of HD-HIV have been
       collected by the GICAT. The median age was 29 years (19-57), 80% were
       IVDU in accordance to the overall epidemiology of HIV infection in
       Italy. At the diagnosis of HD, 17% of pts had AIDS, 22% ARC, 29% PGL and
       34% were asymptomatic; median CD4+ cell count was 275/mm3 (9-1100).
       Lymphocyte predominance (LP) was observed in 4%, nodular sclerosis (NS)
       in 30%, MC in 44% and LD in 21% of pts. In comparison with 125 Italian
       HD pts not infected with HIV, observed in the same period of time at our
       Institution and with a comparable median age, a 4-fold higher frequency
       of the MC and an approx 12-fold higher frequency of the LD subtypes were
       detected among pts with HD-HIV. To determine whether EBV may play a role
       in HD-HIV we characterized EBV (latent membrane protein, LMP-1) in HD
       samples from 18 pts with HD-HIV as well as from a control population of
       104 pts with HD. EBV was detected in 14/18 (78%) HD samples from the
       former group, but only in 27/104 (25%) HD samples from the latter group
       (p less than 0.001) indicating that EBV may be more pathogenetically
       involved in HD-HIV, as previously reported for HIV-associated NHLs.
       31/108 (28%) and 56/108 (51%) pts were Stage III and IV respectively;
       78% of pts had B symptoms. These figures were significantly different
       from those observed in pts with HD of the general population. Twelve pts
       received no treatment, 7 pts radiotherapy (RT) alone, 53 pts were
       treated with standard CT (MOPP, MOPP-/ ABVD +/- RT) and obtained 45%
       complete remission (CR) and 34% partial remission (PR). Twenty-six pts
       were treated prospectively with EBV +/- P (epirubicin, bleomycin,
       vinblastine +/- prednisone) + AZT +/- G-CSF and obtained 58% CR and 27%
       PR. The median survival of all pts was 15.3 mo. Pts with CD4+
       lymphocytes less than or equal to 250/mm3 at onset of HD had a median
       survival or 11.5 months, while those with CD4+ greater than 250/mm3 a
       median of 38 mo (p = 0.002). The median survival of pts without and with
       Aids at onset of HD was 27 mo and 9 mo, respectively, (p less than
       0.001) and for pts achieving or not CR was 11 mo and 58 mo,
       respectively, (p less than  0.001). Pts without B symptoms survived
       significantly longer than pts with B symptoms (43 vs 12 mo, p less than
       0.001). Age more or less than 30 yr, sex, risk group (IVDU vs other
       groups), stage (I + II vs III + IV), extranodal involvement, were not
       factors influencing survival. The median survival of 26 pts treated with
       EBV +/- P + AZT +/- G-CSF was not different (13 mo) from that of pts
       treated with standard CT (17 mo) but a statistically significant lower
       rate of opportunistic infections (OI) occurred in the first group (32%
       vs 74%, p = 0.003) during or after treatment. In conclusion, in
       comparison to HIV-negative HD there is evidence of a significant
       increase of: (1) MC and LD subtypes, (2) EBV expression in tumor tissue.
       Moreover, there is evidence of feasibility or antiretroviral therapy and
       CT with a significant reduction of OI.
 DE    Adult  Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE
       Female  Follow-Up Studies  HIV Infections/*DRUG
       THERAPY/MORTALITY/PATHOLOGY  Herpesviridae Infections/*DRUG
       THERAPY/MORTALITY/PATHOLOGY  *Herpesvirus 4, Human  Hodgkin's
       Disease/*DRUG THERAPY/MORTALITY/PATHOLOGY  Human  Italy/EPIDEMIOLOGY
       Leukocyte Count/DRUG EFFECTS  Lymphoma, AIDS-Related/*DRUG
       THERAPY/MORTALITY/PATHOLOGY  Male  Neoplasm Staging  Survival Rate
       Tumor Virus Infections/*DRUG THERAPY/MORTALITY/PATHOLOGY
       Zidovudine/ADVERSE EFFECTS/*THERAPEUTIC USE  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).