Enfermedad de Hodgkin en pacientes con infección por el virus de la inmunodeficiencia humana. Estudio de 15 casos
Hodgkin's disease in patients infected by the human immunodeficiency virus. Study of fifteen cases
José Tomás Navarro, Josep Maria Ribera**
, Javier Grau, Fuensanta Millá, Montserrat Batlle, Evarist Feliu
Autor para correspondencia
jmribera@ns.hugtip.scs.es
Correspondencia: Dr. J.M. Ribera. Servicio de Hematología-Hemoterapia. Hospital Universitari Germans Trias i Pujol. Canyet, s/n. 08916 Badalona. Barcelona.
Correspondencia: Dr. J.M. Ribera. Servicio de Hematología-Hemoterapia. Hospital Universitari Germans Trias i Pujol. Canyet, s/n. 08916 Badalona. Barcelona.
Servicios de Hematología-Hemoterapia, Hospital Germans Trias i Pujol. Badalona. Universidad Autónoma de Barcelona
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Universidad Autónoma de Barcelona" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "**" "correspondencia" => "Correspondencia: Dr. J.M. Ribera. Servicio de Hematología-Hemoterapia. Hospital Universitari Germans Trias i Pujol. Canyet, s/n. 08916 Badalona. Barcelona." ] ] ] 1 => array:3 [ "autoresLista" => "Carolina Frías, Manuel Vaquero, Guillermo Sirera" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Carolina" "apellidos" => "Frías" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00005" ] ] ] 1 => array:3 [ "nombre" => "Manuel" "apellidos" => "Vaquero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff00010" ] ] ] 2 => array:3 [ "nombre" => "Guillermo" "apellidos" => "Sirera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff00015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Microbiología, Hospital Germans Trias i Pujol. Badalona. Universidad Autónoma de Barcelona" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00005" ] 1 => array:3 [ "entidad" => "Anatomía Patológica, Hospital Germans Trias i Pujol. Badalona. Universidad Autónoma de Barcelona" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff00010" ] 2 => array:3 [ "entidad" => "Unidad VIH. Hospital Germans Trias i Pujol. Badalona. Universidad Autónoma de Barcelona" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff00015" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Hodgkin's disease in patients infected by the human immunodeficiency virus. Study of fifteen cases" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-10-05" "fechaAceptado" => "1999-11-09" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec220504" "palabras" => array:2 [ 0 => "Enfermedad de Hodgkin" 1 => "Infecciones por VIH" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Aunque la enfermedad de Hodgkin (EH) no se considera como una entidad definitoriade sida, en los pacientes infectados por el VIH presenta unas características clínicas ybiológicas diferenciadas.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio de las características clinicopatológicas y analíticas, de la presenciadel virus de Epstein-Barr (VEB) (reacción en cadena de la polimerasa) y del pronóstico en15 pacientes con EH e infección por el VIH diagnosticados en un solo centro durante un períodode 10 años.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Trece enfermos presentaban signos B; en 10 había afección extraganglionar y12 presentaban una EH avanzada. Los tipos histológicos más frecuentes fueron la celularidadmixta (6) y la depleción linfocítica (6). La media (DE) de linfocitos CD4 fue 0,10 (0,08) ×109/l. Se evidenció la presencia del VEB en la biopsia ganglionar en 3 de 4 pacientes analizados.Hubo respuesta completa al tratamiento en 7 de 14 pacientes (50%), la mediana desupervivencia global fue de 26 meses y la probabilidad de supervivencia libre de evento a los2 años fue del 60%.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La EH en los pacientes con infección por el VIH se presenta en estadios avanzados,subtipos histológicos desfavorables, frecuente afección extraganglionar y presencia de signosB. El pronóstico es malo, lo cual se debe, sobre todo, a una baja tasa de respuesta al tratamiento.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In spite of not being considered as an AIDS defining illnes, Hodgkin's disease(HD) has specific clinical and biological features in HIV-infected patients.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Study of clinicopathologic and analytic characteristics, Epstein-Barr virus(EBV) detection (polymerase chain reaction), and prognosis in 15 patients with HD and HIV infection.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Thirteen patients had B symptoms, 10 extranodal involvement and 12 advanced HD.The most frequent histologic subtypes were mixed cellularity (6) and lymphocyte depletion (6).The mean (SD) of CD4 lymphocytes was 0.10 (0.08) × 109/l. The presence of EBV in lymphnode biopsy was demonstrated in 3 out of 4 patients investigated. Complete remission (CR)was achieved in 7 out of 14 treated cases (50%), the median overall survival was 26 monthsand the 2 year event-free survival probability was 60%.</p> <span class="elsevierStyleSectionTitle">Conclussions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In HIV-infected patients, HD presents in advanced stages, unfavourable histologicsubtypes, frequent extranodal involvement and B symptoms. The prognosis is poor, mainlybecause of a low CR rate.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib00005" "etiqueta" => "1." 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