Proefschrift Universiteit Maastricht. / Auteursnaam op omslag: Ingrid A.M. Gisbertz. Met lit. opg. - Met samenvatting in het Nederlands.

Proefschrift Universiteit Maastricht. / Auteursnaam op omslag: Maurice Jansen. Met bibliogr., lit. opg. - Met samenvatting in het Nederlands.

Proefschrift Maastricht. / Met lit. opg. - Met samenvatting in het Nederlands.

VIANA, Daniel de Araújo. Polimorfismos do gene TP53 no linfoma de Hodgkin. 2007. 85 f. Dissertação (Mestrado em Patologia) - Universidade Federal do Ceará. Faculdade de Patologia, Fortaleza, 2007. / Submitted by denise santos (denise.santos@ufc.br) on 2011-12-21T11:21:30Z No. of bitstreams: 1 2007_dis_daviana.pdf: 2983687 bytes, checksum: a560463a3e70aa3380fd982718cb146f (MD5) / Approved for entry into archive by Eliene Nascimento(elienegvn@hotmail.com) on 2012-02-01T16:10:20Z (GMT) No. of bitstreams: 1 2007_dis_daviana.pdf: 2983687 bytes, checksum: a560463a3e70aa3380fd982718cb146f (MD5) / Made available in DSpace on 2012-02-01T16:10:20Z (GMT). No. of bitstreams: 1 2007_dis_daviana.pdf: 2983687 bytes, checksum: a560463a3e70aa3380fd982718cb146f (MD5) Previous issue date: 2007 / Hodgkin lymphoma is a hematololgic B neoplasm occurring at patients within any age, however more likely to affect those from 15 to 40 years-old. The TP53 gene is 20kb length gene with 11 exons that encodes the p53 protein, which main function is related to the conservation and integrity of the genetic code. Most cancers show point mutations in the TP53 sequence. The analysis of these mutations allows a better understanding of the function of the diverse domains of the protein and its relationship to tumor suppression. There is only a few data about TP53 polymorphisms and Hodgkin lymphoma. In this manner, in our study we try to detect polymorphisms within the codons 272, 273, 278, 282, 306 of the exon 8 of the TP53 gene in Hodgkin lymphoma. In our survey we analyzed 42 paraffin-embedded tissues from 2000 to 2006. These samples were prepared for DNA extraction and PCR isolation and amplification of the 137bp fragment of the exon 8 of the TP53 gene, using exclusive primers specially designed to our experiment: PFw8 e PRv8. After PCR amplification, the products of the reaction were purified to the Sequencing reaction. The last part of the experiment encoded the bioinformatics analysis of sequences. DNA extraction and PCR amplification were successfully obtained in our study in all the samples. However, the DNA sequencing was only obtained in 32 samples, but there was no characteristic electropherogram of the analyzed region of the gene. Therefore, it was not possible to determine the presence or absence of SNPs in the TP53 exon 8. / O Linfoma de Hodgkin é uma hemopatia linfóide pode ocorrer em qualquer faixa etária; no entanto, é mais comum na idade adulta jovem, dos 15 aos 40 anos. O TP53 é um gene de 20kb de comprimento que possui 11 éxons situado no cromossomo 17 e codifica a proteína p53, uma proteína cuja principal função está relacionada à preservação da integridade do código genético, e, durante o ciclo celular faz verificação quanto à eventual ocorrência de uma mutação na seqüência do código genético. Na presença dessas mutações, impede que esta célula entre em processo de mitose e complete a divisão celular. A maioria dos cânceres apresenta mutações pontuais na seqüência do TP53. A análise dos padrões dessas mutações é de grande valia uma vez que o conhecimento dessas mutações leva a um melhor entendimento das funções dos vários domínios da proteína p53 e seu envolvimento com o mecanismo de supressão tumoral, além de permitir que essas mutações sejam utilizadas como biomarcadores para desvendar a oncogênese humana. Na literatura vigente, poucos trabalhos abordam a identificação dessas mutações em relação ao linfoma de Hodgkin – forma clássica. Dessa forma, este trabalho se propõe a investigar quantitativa e qualitativamente os padrões de polimorfismos existentes nesta forma do linfoma de Hodgkin. A primeira etapa do nosso experimento constou da seleção de 42 casos de linfonodos diagnosticados como linfoma de Hodgkin entre os anos de 2000 e 2006, arquivados em blocos de parafina. Os casos foram selecionados de pacientes com diagnóstico de linfoma de Hodgkin, sem predileção por idade, sexo ou raça. Em seguida, o DNA foi extraído das amostras selecionadas para reação de PCR, realizada para isolar e amplificar, o fragmento de 137pb correspondente ao éxon 8 do gene TP53, através de primers exclusivos desenhados para o experimento: PFw8 e PRv8. Após a reação, os produtos de PCR foram purificados para reação de Seqüenciamento de DNA, utilizando o seqüenciador automático de DNA da marca ABI Prism® 3100 de 16 capilares (Applied Biosystems). A última etapa aconteceu em laboratório de bioinformática – dry lab, onde as seqüências de DNA obtidas foram analisadas qualitativa- e quantitativamente. Os processos de extração do DNA genômico, amplificação do éxon 8, purificação do produto de PCR foram realizadas com sucesso em todas as amostras obtidas de material parafinizado. No seqüenciamento do DNA parafinizado foi possível determinar, com segurança e confiabilidades previstas em parâmetros convencionais, a seqüência de pelo menos 32 amostras; contudo, não se obteve distinção suficiente dos picos de eletroferogramas para a determinação de eventuais polimorfismos na região analisada. Não foi possível portanto, verificar com margem de segurança razoável, a presença ou ausência de SNPs nas amostras seqüenciadas. Houve, contudo, uma qualificação e competência laboratorial instalada localmente (em Fortaleza), a partir da experiência desenvolvida com o esforço deste trabalho, para continuar a investigação molecular em prol da determinação, em futuro breve, da ocorrência ou não de SNPs no exon 8 do TP53 em linfoma de Hodgkin.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-24T14:40:58Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) LINFOMAS RELACIONADOS AO HIV EM ADULTOS ATENDIDOS NA REDE PÚ.pdf: 3190389 bytes, checksum: 7bff194ffad1d460a15b68dc1d8121ef (MD5) / Made available in DSpace on 2017-07-24T14:40:58Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) LINFOMAS RELACIONADOS AO HIV EM ADULTOS ATENDIDOS NA REDE PÚ.pdf: 3190389 bytes, checksum: 7bff194ffad1d460a15b68dc1d8121ef (MD5) Previous issue date: 2016-08-31 / O presente estudo descreveu os linfomas associados ao vírus da imunodeficiência humana (HIV) e identificou o perfil histológico e imuno-histoquímico predominante, bem como as características clínicas gerais da população, estadiamento inicial do linfoma, terapia realizada suas complicações e o desfecho do tratamento. A pesquisa foi retrospectiva, tipo série de casos. Realizada através da coleta de dados de prontuários médicos nos serviços de arquivo de oncohematologia dos seguintes hospitais: Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE), Hospital de Câncer de Pernambuco (HCP), e Hospital Universitário Oswaldo Cruz (HUOC). Foram analisados 18 prontuários de pacientes infectados com HIV e/ou com aids diagnosticados com linfoma. Foram excluídos aqueles pacientes que não apresentaram estudo imuno-histoquímico do linfoma. Os dados foram alocados em tabelas próprias, que contemplaram todas as variáveis a serem estudadas. Dos 18 pacientes incluídos no estudo, 61,1% eram do sexo masculino, com idade média de 41 anos. Metade dos pacientes tiveram seu diagnóstico de infecção pelo HIV posterior ao diagnóstico do linfoma. Quanto ao estudo anatomopatológico, os tipos mais frequentes foram o linfoma não Hodgkin de células B, somando 8 casos (44,4%), e o Linfoma de Burkitt 5 (27,8%) casos. O estadiamento de Ann Arbor com modificações de Cotswolds em 14 (77,7%) pacientes estava entre III e IV. Sintomas B estiveram presentes em 11 (61,1%) pacientes, doença Bulky também em 11 (61,1%) pacientes, e comprometimento extra linfonodal em metade dos casos. Sobre o tratamento, quatro pacientes foram a óbito já na primeira linha de tratamento e dois foram refratários, enquanto que seis pacientes tiveram resposta parcial e apenas um obteve resposta completa. Entre os pacientes acompanhados na segunda linha de tratamento um foi a óbito. Dentre os que seguiram para a terceira linha de tratamento dois foram a óbito, e o único paciente que se submeteu ao quarto tratamento também evoluiu para o óbito. Em acordo com a literatura, observamos que os pacientes com diagnóstico de linfoma associado ao HIV apresentaram um estadiamento clínico inicial avançado, e evoluíram com baixas taxas de resposta à quimioterapia o que pode estar relacionado com as frequentes complicações infecciosas relacionadas ao tratamento, à não utilização do anticorpo monoclonal anti-CD20 no tratamento, ao retardo do diagnóstico, tanto do linfoma como do HIV e às baixas condições de saúde básica e de vida da população em estudo, reforçando a necessidade de melhores condições de acesso à saúde. / The present study described lymphomas associated with human immunodeficiency virus (HIV) and identified the predominant histological and immunohistochemical profile, as well as the general clinical characteristics of the population, initial lymphoma staging, therapy performed, its complications and treatment outcome. The research was of a retrospective, case series type. This was done through the collection of data from medical records in the onco-hematology archive services of the following hospitals: Clinical Hospital of the Federal University of Pernambuco (HC-UFPE), Pernambuco Cancer Hospital (HCP), and Oswaldo Cruz University Hospital (HUOC). The medical records of 18 patients were analyzed who had been infected with HIV and/or AIDS and diagnosed with lymphoma. Patients who did not present an immunohistochemical study of lymphoma were excluded. The data were allocated to separate tables, which included all the variables to be studied. Of the 18 patients included in the study, 61.1% were male, with a mean age of 41 years. Half of the patients had their diagnosis of HIV infection following the diagnosis of lymphoma. As for the anatomical and pathological study, the most frequent types were B-cell non-Hodgkin’s lymphoma, adding up to 8 cases (44.4%), and Burkitt’s lymphoma, 5 cases (27.8%). The Ann Arbor staging with Cotswolds modifications in 14 (77.7%) patients was between III and IV. B symptoms were present in 11 (61.1%) patients, bulky disease also in 11 (61.1%) patients, and extra-lymph node involvement in half of the cases. Concerning treatment, four patients died during the first line of treatment and two were refractory, while six patients had partial response and only one had a complete response. Among the patients followed in the second-line treatment, one died. Among those who went to the third-line treatment, two died, and the only patient who underwent the fourthline treatment also died. According to the literature, we observed that patients diagnosed with HIV-associated lymphoma presented an advanced initial clinical staging, and evolved with low rates of response to chemotherapy which may be related to frequent infectious complications related to treatment, non-use of the anti-CD20 monoclonal antibody in the treatment, delayed diagnosis of both lymphoma and HIV, and low basic health and life conditions of the study population, reinforcing the need for better living conditions and access to health care.

Orientador: Jose Vassallo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-07-19T18:15:52Z (GMT). No. of bitstreams: 1 Aranha_FranciscoJosePenteado_M.pdf: 2465435 bytes, checksum: 817fa99d791a5717b042de699bfe775a (MD5) Previous issue date: 1995 / Resumo: Os linfomas não-Hodgkin englobam um conjunto de entidades nosológicas que apresentam características comuns quanto à clínica e à histologia, sendo genericamente divididos em alto e baixo graus de malignidade. Um grande problema tem sido a sistematização dos vários subtipos histológicos dos linfomas não-Hodgkin, tendo-se chegado a uma classificação mais adequada na década de 70, à luz dos novos conhecimentos da imunologia e melhor compreensão da fisiopatologia dos mesmos. Entre todas, escolhemos neste trabalho a classificação de Kiel, que está de acordo com os novos conceitos imunológicos, relaciona melhor os linfomas não-Hodgkin com a ontogenia dos linfócitos, apresenta uma boa reprodutibilidade entre os hemopatologistas, e apresenta tambémboa correlação clínica. Estudamos 89 casos de linfomas não-Hodgkin diagnosticados no Departamento de Anatomia Patológica da UNICAMP, entre os anos de 1978-1986. Ao todo, diagnosticamos, utilizando a morfologia tradicional adicionada à imuno-histoquímica, 72 casos (80,9%) como linfoma não-Hodgkin de origem B, 12 casos (13,5%) como linfoma não-Hodgkin T. Cinco casos (5,6%) de linfoma linfoblástico não puderam ser classificados como linfoma não-Hodgkin B ou T e foram considerados como indeterminados. Em 63 casos (71%) realizamos o estudo imuno-histoquímico com os anticorpos monoclonais L-26 (CD20) e UCHL-l (CD45RO), respecti~amente pan B e pan T. Com anticorpo monocional pan B, obtivemos 46 caSbs positivos (73%), com anticorpo monoclonal UCHL-lseis casos positivos (9,5%). Em 11 casos (17,5%) não obtivemos nenhuma reação. Com o acréscimo da reação de imunoperoxidase às colorações habituais dos laboratórios de patologia, conseguimos definir a origem celular do linfoma não-Hodgkin em onze casos (12,7%), onde a impressão morfológica não fora suficiente. Os subtipos histológicos e imunofenotípicos de linfomas não-Hodgkin de nossa casuística equivalem, globalmente, aos dados dos países do 10 mundo. Além do mais, mesmo a utilização de um painel imuno-histoquímico reduzido permitiu a fenotipagem de grande parte dos casos / Abstract: The non-Hodgkin lymphomas belong to a group of nosologic entities which present ordinary characteristics in relation to both clinical and histology, being in general divided into high and low levels of malignity. The systematization of the many subtypes of the non-Hodgkin lymphomas has been a great problem. Only in the 70's, in the light of the immunological knowledge and due to a better understanding of their physiopathology, a more adequate classification was reached. Among all, Kiel classification was chosen, since it is in accordance of relationship between the non-Hodgkin lymphomas with the lymphocyte ontogenesis, as it presents a good receptivity among hemopathologists as well as presenting a good clinical correlation. Eighty nine cases ofnon-Hodgkin lymphomas which were diagnosed at the Pathological Anatomy Department at UNICAMP, from 1978 to 1986 were studied. Only through the use oftraditional morphology, 72 cases (80,9%) as non-Hodgkin lymphomas ofB-cell origin and 12 cases (13,5%) as non-Hodgkin T-celllymphomas. Five cases (5,6%) of lymphoblastic lymphoma could not be classified as non-Hodgkin lymphoma neither as B nor as T and were considered indeterminate. In 63 cases (71%) the immuno-histochemical study with monoclonal antibodies L26 (CD 20) and UCHL-i (CD45RO), pan B and pan T, respectively, was carried out: with the monoclonal antibodies pan B 46 positive cases (73%) were Gbtained; with the monoclonal UCHL-l antibodies 6 positives cases were established; 11 cases (17,5%) presented no reaction. With addition of immunoperoxydase reaction to the usual coloration of Pathology laboratory it was possible to define the cellular origin of the non-Hodgkin lymphoma in 11 cases (12,7%), where the morphological impression proved to be insufficient. The histologycal and immunophenotypic subtypes of non-Hodgkin lymphomas in our registered cases are globally equivalent to the first world countries findings. Furthermore, even the utilization of a reduced immuno-histochemical panel allowed the classification of phenotypes in the great majority of the cases / Mestrado / Mestre em Clinica Medica

Das Non-Hodgkin-Lymphom (NHL) steht an siebter Stelle der Inzidenzen aller Krebserkrankungen, mit jährlich steigender Tendenz. Wie kann einer so gefährlichen und heterogenen Krankheitsentität in der heutigen Medizin angemessen begegnet werden? Neben etablierten Therapien, die geraden bei rezidivierten oder refraktären NHL an ihre Grenzen stoßen, bieten experimentelle Therapieansätze neue Hoffnung: Blinatumomab ist ein bispezifischer Antikörper, der durch seine beiden Domänen als Adapter für die T-Zelle und die Tumor-Zelle fungiert und eine Zytolyse der malignen B-Zelle induziert. Bei der ALL fand Blinatumomab schon Anwendung in mehreren klinischen Studien und wurde im Dezember 2014 von der FDA in den USA zur Behandlung von Philadelphia-Chromosom-negativer rezidivierten/ refraktären B-Zell Vorläufer-ALL zugelassen. Als erste klinische Studie an NHL-Patienten wurde von 2004-2011 die MT103/104-Studie veranlasst. Im Zuge dieser unverblindeten, multizentrischen Phase I/II Studie wurden 76 Patienten mit refraktärem und rezidiviertem NHL vier bis acht Wochen mit Blinatumomab als Dauerinfusion behandelt und hierbei Informationen zu Toxizität und Tolerabilität gesammelt. Mit der Langzeitbeobachtung der Würzburger Kohorte aus dieser Studie befasst sich die vorliegende Arbeit. Ziel ist es zunächst, festzustellen, wie lange die Patienten nach Blinatumomab-Therapie im Zuge der MT103/104 Studie gesamt, rezidiv- oder therapiefrei überlebten und ob bei einem bestimmten Patientensubkollektiv ein besonders vorteilhaftes Langzeitüberleben gezeigt werden kann. Die Frage nach der Sicherheit von Blinatumomab beantwortet die Erfassung des Langzeitnebenwirkungsspektrums: Somit werden als zweiter Endpunkt die häufigsten Gründe für Krankenhausaufenthalte nach Blinatumomabtherapie, eventuelle Häufungen einer spezifischen Nebenwirkungsentität und die Reversibilität der unter der Therapie aufgetretenen Nebenwirkungen mit einem selbst entwickelten Fragebogen erfasst. Der MoCA-Test soll neurokognitive Langzeittoxizitäten ausschließen. Die Arbeit konnte nicht nur zeigen, dass Patienten, die auf Blinatumomab ansprachen gegenüber den Patienten ohne Ansprechen ein deutlich längeres Überleben zeigten, sie bestätigte die Wichtigkeit des Erhalts der effektiven Dosis von 60 µg/m²/24h für das Erreichen und den Erhalt der Progressionsfreiheit. Sechs Patienten waren bei Beobachtungsende noch in Remission. Die unterschiedlichen Eindosierungsmodi hatten keinen Effekt auf das Langzeitüberleben, können aber nebenwirkungsbedingte Therapieabbrüche während der Therapie minimieren. Alle während der Therapie aufgetretenen Nebenwirkungen waren in der Langzeitnachbeobachtung vollständig reversibel. Am häufigsten mussten Patienten auf Grund von Infektionen im Verlauf hospitalisiert werden, bei zwei Patienten traten zusätzliche Tumorerkrankungen auf, die allerdings nicht mit der Blinatumomab-Therapie assoziiert waren. Die Rate der Transformationen von indolenten in aggressive NHL war nicht erhöht. Im MoCA-Test lassen sich keine Häufungen von neurokognitiven Defiziten finden. Blinatumomab zeigt sich auch in der Langzeitbeobachtung als ein für die Behandlung von rezidivierten und refraktären NHLs effektives und sicheres Medikament. / The incidence of NHL ranks on seventh position of all cancer types with a tendency to increase year by year. How can we face such a dangerous and heterogenous entity in today’s medicine? Besides established therapy options, which find their boundaries in relapsed or refractory NHL, new, experimental approaches raise new hope: Blinatumomab is a bispecific antibody, which is able to link T-cells to tumor cells, and thus induces cytolysis of the malign B-cell. Blinatumomab was applied in ALL patients in multiple clinical trials and was admitted by the FDA for treatment of Philadelphia-chromosome negative, relapsed or refractory B-cell precursor ALL in December 2014 in the U.S.. The first clinical trial in NHL patients (MT103/104) was initiated 2004-2011. During this open-labeled, multicenter, phase I/II study, 76 patients with relapsed or refractory NHL received Blinatumomab for four to eight weeks as a continous intravenous infusion, whilst data about tolerability and toxicity were collected. The aim of this work is the long-term follow-up of the patients, who were treated in Wuerzburg. First and foremost, the goal is to determine overall, progression-free and therapy-free survival of the patients, who received Blinatumomab during the MT103/104 trial, and if a certain subgroup shows an outstanding long-term survival. The second goal is to acquire long-term safety data and collect the possible spectrum of side-effects after Blinatumomab treatment. Therefore, the most frequent reasons for hospitalization after Blinatumomab administration, potential accumulation of certain side-effects and the reversibility of the witnessed adverse events were recorded by a self-generated questionnaire. The MoCA-test is to exclude long-term neurotoxicity. This work shows, that patients who responded to blinatumomab had a significantly longer OS, PFS and TFS in comparison to patients who did not respond to blinatumomab. The work also confirmed the importance of treatment on a target dose (60 µg/m²/d) in order to achieve and preserve PFS. Six patients were still in remission at the end of observation. The different steps of dosing (single, double, flat) couldn’t show any effect on the long-term survival, but where able to minimize side-effect-related treatment dropouts. Every single witnessed adverse-event during therapy is fully reversible. The most common reason for hospitalization after treatment cessation were infections, two patients experienced other malignancies, however not associated with Blinatumomab treatment. The number of transformations from indolent to aggressive lymphomas was not elevated. The MoCA-test doesn’t show any accumulation of neurocognitive impairment. Thus, Blinatumomab is safe and effective in the treatment of relapsed and refractory NHL.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine (Internal Medicine) / Hodgkin lymphoma (HL) is a malignancy of lymphoid cells that was first described by Thomas Hodgkin in 1832. It is recognized histologically by the presence of the characteristic Reed Sternberg cells, bathed in a reactive cellular background of inflammatory cells. Hodgkin lymphoma is less common than Non-Hodgkin Lymphoma (NHL) and accounts for approximately 10-20 % of all the lymphomas encountered. It is most often seen in young adults, with a peak frequency in the third decade of life. Hodgkin lymphoma is characterized by the orderly spread of disease from one lymph node group to another (contiguous spread and centripetal distribution) and by the development of systemic symptoms, particularly with advanced stage disease. True extra nodal disease is uncommon. Pathologically, Hodgkin lymphoma is categorized into two groups: Nodular lymphocyte predominant Hodgkin lymphoma which accounts for about 5% and Classical Hodgkin lymphoma which accounts for 95%. Classical Hodgkin lymphoma is further subdivided into four subtypes: Nodular sclerosis classical Hodgkin lymphoma, Mixed cellularity classical Hodgkin lymphoma, Lymphocyte rich classical Hodgkin lymphoma and Lymphocyte depleted classical Hodgkin lymphoma. Once the diagnosis is confirmed on a lymph node or tissue biopsy, a complete work up is done, which includes blood investigations, a bone marrow aspirate and biopsy and appropriate radiological investigations. Following on this, the treatment is individualized and includes both supportive care and specific therapy. The specific initial treatment of Hodgkin lymphoma involves combination chemotherapy and where necessary involved field radiotherapy. Cure is a realistic goal in more than 90% of patients with early stage disease. A delicate balance exists vi between optimal initial treatment and the development of late complications of the disease, mainly related to treatment. The last decade has witnessed the emergence of Hodgkin lymphoma occurring with increasing frequency in association with the Human Immunodeficiency virus (HIV) infection. The relative risk is 10-20 fold higher with HIV seropositivity, compared to the general population. HIV associated Hodgkin lymphoma is generally more aggressive, presents with advanced stage disease, frequent ‘B’ symptoms, less favorable histology, more frequent bone marrow involvement and overall a poorer prognosis compared to Hodgkin lymphoma in HIV seronegative individuals. This study was aimed at exploring and defining the changing pattern of Hodgkin lymphoma at Chris Hani Baragwanath Academic Hospital (CHBAH) from January 2005 to December 2012. Other objectives were to review: (i) the impact of HIV on the clinical pattern of disease and (ii) the different treatment options and the outcome of the patients. Patients and Methods This was a retrospective review of all adult patients with Hodgkin lymphoma seen at the Clinical Hematology Unit, Department of Medicine from January 2005 to December 2012 at CHBAH. Descriptive analysis was conducted through the computation of frequency tables for categorical variables and appropriate measures of central tendency i.e. mean ± SD/median (IQR) for continuous variables. Kaplan Meier survival curves were plotted to determine the survival probability of the patients based on demographic and clinical characteristics. vii Results A total of 150 patients with a confirmed diagnosis were included in the study. Ninety three percent of the patients were of black ethnicity. There were 84 males (56%) and 66 females (44%), with a male to female ratio of 1.27:1. The median age of the patients was 37 years, with a peak frequency in the third and fourth decades of life. HIV seropositivity was noted in 90 patients (60%), with the remaining 60 patients (40%) being seronegative. For the whole group of 150 patients, lymphadenopathy was the most common presenting feature (92.7%). ‘B’ symptoms were present in 74.7% of the patients. Advanced stage disease was noted in 74% of the patients and a performance status of ≥2 was evident in 66.7% of the patients. A comparison of the HIV seropositive and HIV seronegative patients shows that there is a statistically significant difference between the histological subtypes (mixed cellularity with HIV seropositivity and nodular sclerosis with HIV seronegativity), TB association (higher with HIV seropositivity) and more bone marrow involvement with HIV seropositivity. However, the median survival was shorter in HIV seropositive compared to HIV seronegative individuals. Conclusion As compared to the current literature on Hodgkin lymphoma (particularly from the developed world), our study showed a high prevalence of HIV and TB, in association with Hodgkin lymphoma. There is a paradigm shift at our institution, from an early period in the 1980’s with no HIV seropositivity in association with HL, to <50% in the 1990’s and early 2000’s, to > 50% in the last decade. The association between HIV and HL has an impact on the clinical presentation and outcome of the patients. Therefore, health care workers need to be aware of this emerging and increasing association between HIV and Hodgkin lymphoma. / GR2018

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 4 uppsatser.