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JNCI Monographs 1998 1998(23):37-42;
© 1998 by Oxford University Press
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Journal of the National Cancer Institute Monographs, No. 23, 37-42, 1998
© 1998 Oxford University Press

Hodgkin's Disease in the Setting of Human Immunodeficiency Virus Infection

Alexandra M. Levine*

*Correspondence to: Alexandra M. Levine, M.D., Division of Hematology, University of Southern California (USC), USC/Norris Cancer Hospital, 1441 Eastlake Ave., MS 34, Los Angeles, CA 90033.

Although Hodgkin's disease (HD) is not usually associated with congenital or acquired immunodeficiency disorders, recent evidence would suggest a statistically significant increase in HD among individuals infected with human immunodeficiency virus (HIV). In the setting of underlying HIV infection, clinical and pathologic characteristics of HD may differ from usual expectations. Thus, 70%-100% of HIV-infected patients with HD present with systemic "B" symptoms. Likewise, disseminated, stage III or IV disease is reported in approximately 75%-90%. Bone marrow is a common site of extranodal HD, occurring in 40%-50%. Complete response rates after multiagent chemotherapy range from approximately 45% to 70%, although median survival has been only in the range of approximately 18 months. Hematologic toxicity from multiagent chemotherapy may be substantial, even with the use of hematopoietic growth factor support. It is apparent that new strategies of therapeutic intervention must be explored.


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