Hodgkin's disease in 50 intravenous drug users with HIV-infection

S. Monfardini, U. Tirelli, E. Vaccher, D. Errante, G. Rezza, R. Talamint, F. Albericci, T. Barbui, C. Bernasconi, A. Cajozzo, A. Cargnel, M. Clerici, De Lalla, P. Dessalvi, F. Fiaccadori, P. L. Garavelli, M. Giudici, F. Gherlinzoni, G. Lambertenghi Deliliers, A. LazzarinG. Luzi, R. Luzzati, A. Malfitano, F. Mandelli, S. Marigo, V. Montesarchio, N. Moroni, F. Puppo, E. Raise, G. Rizzardini, M. Rizzi, E. Rossi, G. Saliva, A. Scanni, A. Sinicco, A. Vaglia, R. Foà, F. Gavosto

Research output: Contribution to journalArticle

Abstract

Fifty cases of Hodgkin's disease in intravenous drug users (IVDU) have been collected by the Italian Cooperative Group on AIDS-Related Tumors (G.I.C.A.T.). Ninety-two per cent of the patients were males; the median age was 26 years. Persistent generalized lymphadenopathy (PGL) at onset was present in 54% of patients, AIDS in 9%, ARC in 9% while 28% were simply HIV-positive. The initial median absolute number of CD4 lymphocytes was 264/mmc. Opportunistic infections were diagnosed in 20% of patients. In most patients the histological pattern was that of mixed cellularity and lymphocytic depletion (76%). In almost half the initial symptom was a persistent lymph node enlargement due to PGL. In the majority of patients (58%) only a clinical staging and bone marrow biopsy could be performed due to the presence of opportunistic infections, rapid disease progression or refusal of pathologic staging procedures. One patient presented with a Waldeyer's ring involvement, but no other unusual presentations were observed. After MOPP alternated or followed by ABVD or MOPP alone, 15/29 CR (52%) and 14/29 PR (48%) were observed. The median duration of CR was 14 months, while the median survival of CR has not been reached; the median survival of patients treated with chemotherapy with CD4 values at presentation {geq}400/mmc was significantly superior to that in those with CD4 <400/mmc. The overall median survival was 16 months. Twenty-eight per cent of patients receiving chemotherapy + radiotherapy developed opportunistic as well as non-opportunistic infections (21%). Lethal hepatic toxicity was observed in 2 patients. In conclusion, Hodgkin's disease in IVDU was not found to be associated with unusual presentations, as previously reported for homosexuals. Complete remissions could be achieved in over 50% of patients, but in IVDU non-opportunistic infections in addition to opportunistic infections may also limit treatment administration. The presence of parenchymal functional impairment due to drug abuse, or drug abuse-related infections, such as pneumonia, endocarditis and hepatitis, should lead to the choice of antitumour agents with no or only minor potential liver, lung and cardiac toxicity.

Original languageEnglish
Pages (from-to)375-384
Number of pages10
JournalLeukemia and Lymphoma
Volume3
Issue number5-6
DOIs
Publication statusPublished - 1991

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Keywords

  • HIV infection
  • Hodgkin's discase
  • Intravenous drug users

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Monfardini, S., Tirelli, U., Vaccher, E., Errante, D., Rezza, G., Talamint, R., Albericci, F., Barbui, T., Bernasconi, C., Cajozzo, A., Cargnel, A., Clerici, M., Lalla, D., Dessalvi, P., Fiaccadori, F., Garavelli, P. L., Giudici, M., Gherlinzoni, F., Deliliers, G. L., ... Gavosto, F. (1991). Hodgkin's disease in 50 intravenous drug users with HIV-infection. Leukemia and Lymphoma, 3(5-6), 375-384. https://doi.org/10.3109/10428199109070281