Hodgkin's disease and human immunodeficiency virus infection: clinicopathologic and virologic features of 114 patients from the Italian Cooperative Group on AIDS and Tumors.

Tirelli, Umberto; Errante, D.; Dolcetti, Riccardo; Gloghini, Annunziata; Serraino, Diego; Vaccher, Emanuela; Franceschi, Silvia; Boiocchi, M; Carbone, Antonino

doi:10.1200/jco.1995.13.7.1758

Cited by 213 publications

(144 citation statements)

References 34 publications

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“…Besides being more aggressive and involving bone marrow more frequently. HD in HIV-infected patients seems to be associated with Epstein-Barr -irus more commonly than in the gieneral population (Tirelli et al 1995).…”

Section: Resultsmentioning

confidence: 91%

Risk of cancer other than Kaposi's sarcoma and non-Hodgkin's lymphoma in persons with AIDS in Italy

et al. 1998

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Record linkage was carried out between the national Registry of AIDS and 13 Cancer Registries (CRs) covering, in 1991, about 15% of the Italian population. Observed and expected numbers of cancers and standardized incidence ratios (SIRs) were assessed in 6067 persons with AIDS, for a total of 25,759 person-years. Significantly increased SIRs were found for Hodgkin's disease [8.9, 95% confidence interval (CI) 4.4-16.0], in which seven of 11 cases were of mixed cellularity type; invasive carcinoma of the cervix uteri (15.5; 95% CI 4.0-40.1); and non-melanomatous skin cancer (3.0, 95% CI 1.3-5.9), in which five of eight cases were basal cell carcinoma. An excess was also seen for brain tumours, but this may be partly due to misdiagnosis of brain non-Hodgkin's lymphoma or other brain diseases occurring near the time of the AIDS diagnosis. The risk for all cancer types, after exclusion of Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL), was approximately twice the general population risk. An increased SIR for Hodgkin's disease in persons with AIDS is thus confirmed, though it is many times smaller than that for NHL. An association with invasive carcinoma of the cervix is also shown at a population level. The excess of non-melanomatous skin cancer seems to be lower than in transplant recipients.

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Section: Resultsmentioning

confidence: 91%

Risk of cancer other than Kaposi's sarcoma and non-Hodgkin's lymphoma in persons with AIDS in Italy

et al. 1998

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“…All tumors represented initial diagnoses, had been reviewed originally for uniform diagnosis and histologic subtyping, and had been preserved in fixative before being assayed for EBV. Twenty HIV-positive subjects were excluded from analyses because of the very high proportion of such patients with EBV-positive tumors and the distinctive clinical behavior of HIV-associated HD (Tirelli et al, 1995).…”

Section: Methodsmentioning

confidence: 99%

Epstein‐Barr virus‐associated Hodgkin's disease: Epidemiologic characteristics in international data

et al. 1997

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Hodgkin's disease (HD) has long been suspected to have an infectious precursor, and indirect evidence has implicated Epstein-Barr virus (EBV), a ubiquitous herpesvirus, as a causal agent. Recent molecular studies using EBER in situ hybridization or latency membrane protein-1 (LMP-1) immunohistochemistry have identified EBV latent infection in up to 50% of HD tumors. However, the epidemiologic features of these cases have not been examined in detail. To explore the epidemiology of EBV-positive HD so as to understand the role of EBV in HD etiology more clearly, this project accumulated patient data from 14 studies that had applied these EBV assays to HD tumors. With information on age at diagnosis, sex, ethnicity, histologic subtype, country of residence, clinical stage and EBV tumor status from 1,546 HD patients, we examined risk for EBV-positive disease using logistic regression. Forty percent of subjects had EBV-positive tumors, and EBV prevalence varied significantly across groups defined by the study variables. Odds ratios (OR) for EBV-associated HD were significantly elevated for Hispanics vs. whites (OR 5 4.1), mixed cellularity vs. nodular sclerosis histologic subtypes (OR 5 7.3, 13.4, 4.9 for ages 0-14, 15-49, 501 years), children from economically less-developed vs. more-developed regions and young adult males vs. females (OR 5 2.5). These findings suggest that age, sex, ethnicity and the physiologic effects of poverty may represent biologic modifiers of the EBV association and confirm that this association is strongly but variably linked to histologic subtype. The data augment biologic evidence that EBV is actively involved in HD pathogenesis in some cases but describe epidemiologic complexity in this process. Int.

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“…3 When these lymphomas occur in association with HIV infection, they tend to present with an advanced stage, B symptoms, extranodal sites of disease and commonly bone marrow involvement. [4][5][6] Prognostic factors associated with shortened survival for HIV-associated NHL include age 435 years, a history of intravenous drug abuse, stage III or IV disease, CD4 counts o100 and an elevated LDH. 7 In addition, the international prognostic index has been found to be highly correlated with survival.…”

Section: Clinical Features Of Hiv-associated Lymphomasmentioning

confidence: 99%

Should HIV-positive patients with lymphoma be offered stem cell transplants?

Krishnan

Zaia

Forman

2003

Bone Marrow Transplant

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Summary:Advances in effective antiretroviral therapy for HIV infection have made high-dose therapy and autologous stem cell transplantation possible in patients with HIVassociated lymphomas. Regimen-related toxicity is not significantly increased when antiretroviral therapy is combined with high-dose chemoradiotherapy. Durable engraftment can be seen with autologous stem cell rescue. Infectious complications can be managed with a combination of surveillance and prophylaxis. Long-term remissions of these high-risk lymphomas can be achieved with this approach. This suggests that patients with HIVassociated lymphomas should be considered for autologous transplantation in a manner similar to HIV-negative lymphoma patients Bone Marrow Transplantation (2003) 32, 741-748.

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Hodgkin's disease and human immunodeficiency virus infection: clinicopathologic and virologic features of 114 patients from the Italian Cooperative Group on AIDS and Tumors.

Abstract: Our virologic findings indicate that HIV-related HD is more closely associated with EBV than HD in the general population. The peculiar clinicopathologic findings, the role of some prognostic factors, and the possibility of cure of HIV-related HD have been demonstrated.

Cited by 213 publications

References 34 publications

Risk of cancer other than Kaposi's sarcoma and non-Hodgkin's lymphoma in persons with AIDS in Italy

Risk of cancer other than Kaposi's sarcoma and non-Hodgkin's lymphoma in persons with AIDS in Italy

Epstein‐Barr virus‐associated Hodgkin's disease: Epidemiologic characteristics in international data

Should HIV-positive patients with lymphoma be offered stem cell transplants?

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