RESUMEN
OBJECTIVE: To analyze the factors associated with survival in the largest cohort of individuals with HIV and lymphoma so far described in Brazil. DESIGN: A retrospective, observational, multicenter study involving five institutions in São Paulo, Brazil. METHODS: The medical records of consecutive patients with HIV diagnosed with lymphoma between January 2000 and December 2019 were screened. Inclusion criteria consisted of age over 17âyears and a biopsy-confirmed diagnosis of lymphoma. The data collected included age, sex, staging (Ann Arbor system), duration of HIV infection, CD4 + lymphocyte count, HIV viral load, lactate dehydrogenase, erythrocyte sedimentation rate and serum beta-2-microglobulin levels, treatment and outcome. RESULTS: Overall, 276 patients were included. Median age was 42âyears. Most patients were male (74.3%) and with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (28.6% and 46.4%, respectively). Most had non-Hodgkin lymphomas (89.2%, n â=â246), particularly diffuse large B-cell lymphoma (40.9%) and Burkitt lymphoma (26.4%). Hodgkin lymphoma accounted for 9.4%. Advanced stages III/IV were predominant (86.8%). HIV viral load at the moment of lymphoma diagnosis was detectable in 52.9% of patients. A CD4 + cell count of <200âcells/µl was recorded for 53% of the patients. Most patients (62.4%) were on combination antiretroviral therapy. The factors that significantly affected survival were: the ECOG performance status, lymphoma subtype, staging, beta-2-microglobulin level, central nervous system (CNS) infiltration, site of CNS infiltration, relapsed/refractory lymphoma and International Prognostic Index score. CONCLUSIONS: HIV status, CD4 + -lymphocyte count and relapsed/refractory disease affected survival. Rituximab did not appear to improve outcome in HIV-related lymphomas.
Asunto(s)
Infecciones por VIH , Linfoma Relacionado con SIDA , Linfoma de Células B Grandes Difuso , Linfoma no Hodgkin , Humanos , Masculino , Adulto , Adolescente , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/complicaciones , Estudios Retrospectivos , Brasil/epidemiología , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma Relacionado con SIDA/tratamiento farmacológico , Linfoma Relacionado con SIDA/complicaciones , Pronóstico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversosRESUMEN
EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) is a preferred regimen for HIV-non-Hodgkin lymphomas (HIV-NHLs), which are frequently Epstein-Barr virus (EBV) positive or human herpesvirus type-8 (HHV-8) positive. The histone deacetylase (HDAC) inhibitor vorinostat disrupts EBV/HHV-8 latency, enhances chemotherapy-induced cell death, and may clear HIV reservoirs. We performed a randomized phase 2 study in 90 patients (45 per study arm) with aggressive HIV-NHLs, using dose-adjusted EPOCH (plus rituximab if CD20+), alone or with 300 mg vorinostat, administered on days 1 to 5 of each cycle. Up to 1 prior cycle of systemic chemotherapy was allowed. The primary end point was complete response (CR). In 86 evaluable patients with diffuse large B-cell lymphoma (DLBCL; n = 61), plasmablastic lymphoma (n = 15), primary effusion lymphoma (n = 7), unclassifiable B-cell NHL (n = 2), and Burkitt lymphoma (n = 1), CR rates were 74% vs 68% for EPOCH vs EPOCH-vorinostat (P = .72). Patients with a CD4+ count <200 cells/mm3 had a lower CR rate. EPOCH-vorinostat did not eliminate HIV reservoirs, resulted in more frequent grade 4 neutropenia and thrombocytopenia, and did not affect survival. Overall, patients with Myc+ DLBCL had a significantly lower EFS. A low diagnosis-to-treatment interval (DTI) was also associated with inferior outcomes, whereas preprotocol therapy had no negative impact. In summary, EPOCH had broad efficacy against highly aggressive HIV-NHLs, whereas vorinostat had no benefit; patients with Myc-driven DLBCL, low CD4, and low DTI had less favorable outcomes. Permitting preprotocol therapy facilitated accruals without compromising outcomes. This trial was registered at www.clinicaltrials.gov as #NCT0119384.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Genes myc , Linfoma Relacionado con SIDA/tratamiento farmacológico , Linfoma no Hodgkin/tratamiento farmacológico , Adulto , Anciano , Fármacos Anti-VIH/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Recuento de Linfocito CD4 , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , ADN Viral/sangre , Doxorrubicina/administración & dosificación , Doxorrubicina/efectos adversos , Esquema de Medicación , Etopósido/administración & dosificación , Etopósido/efectos adversos , Femenino , Infecciones por VIH/tratamiento farmacológico , VIH-1/efectos de los fármacos , Infecciones por Herpesviridae/complicaciones , Infecciones por Herpesviridae/virología , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/aislamiento & purificación , Herpesvirus Humano 8/genética , Herpesvirus Humano 8/aislamiento & purificación , Inhibidores de Histona Desacetilasas/administración & dosificación , Inhibidores de Histona Desacetilasas/efectos adversos , Humanos , Estimación de Kaplan-Meier , Linfoma Relacionado con SIDA/complicaciones , Linfoma Relacionado con SIDA/genética , Linfoma Relacionado con SIDA/virología , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/genética , Linfoma no Hodgkin/virología , Masculino , Persona de Mediana Edad , Neutropenia/inducido químicamente , Prednisona/administración & dosificación , Prednisona/efectos adversos , Supervivencia sin Progresión , Estudios Prospectivos , Rituximab/administración & dosificación , Rituximab/efectos adversos , Trombocitopenia/inducido químicamente , Resultado del Tratamiento , Vincristina/administración & dosificación , Vincristina/efectos adversos , Carga Viral/efectos de los fármacos , Vorinostat/administración & dosificación , Vorinostat/efectos adversosRESUMEN
People living with HIV (PLHIV) are more likely than the general population to develop AIDS-defining malignancies (ADMs) and several non-ADMs (NADMs). Information is lacking on survival outcomes and cause-specific mortality after cancer diagnosis among PLHIV. We investigated causes of death within 5 years of cancer diagnosis in PLHIV enrolled in European and North American HIV cohorts starting antiretroviral therapy (ART) 1996-2015, aged ≥16 years, and subsequently diagnosed with cancer. Cancers were grouped: ADMs, viral NADMs and nonviral NADMs. We calculated cause-specific mortality rates (MR) after diagnosis of specific cancers and compared 5-year survival with the UK and France general populations. Among 83,856 PLHIV there were 4,436 cancer diagnoses. Of 603 deaths after ADM diagnosis, 292 (48%) were due to an ADM. There were 467/847 (55%) and 74/189 (39%) deaths that were due to an NADM after nonviral and viral NADM diagnoses, respectively. MR were higher for diagnoses between 1996 and 2005 versus 2006-2015: ADMs 102 (95% CI 92-113) per 1,000 years versus 88 (78-100), viral NADMs 134 (106-169) versus 111 (93-133) and nonviral NADMs 264 (232-300) versus 226 (206-248). Estimated 5-year survival for PLHIV diagnosed with liver (29% [19-39%]), lung (18% [13-23%]) and cervical (75% [63-84%]) cancer was similar to general populations. Survival after Hodgkin's lymphoma diagnosis was lower in PLHIV (75% [67-81%]). Among ART-treated PLHIV diagnosed with cancer, MR and causes of death varied by cancer type, with mortality highest for liver and lung cancers. Deaths within 5 years of NADM diagnoses were more likely to be from cancer than AIDS.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/etiología , Enfermedad de Hodgkin/mortalidad , Neoplasias Hepáticas/mortalidad , Neoplasias Pulmonares/mortalidad , Linfoma Relacionado con SIDA/mortalidad , Neoplasias del Cuello Uterino/mortalidad , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Adulto , Femenino , Francia/epidemiología , Enfermedad de Hodgkin/complicaciones , Enfermedad de Hodgkin/epidemiología , Humanos , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/epidemiología , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/epidemiología , Linfoma Relacionado con SIDA/complicaciones , Linfoma Relacionado con SIDA/epidemiología , Persona de Mediana Edad , Pronóstico , Tasa de Supervivencia , Reino Unido/epidemiología , Neoplasias del Cuello Uterino/complicaciones , Neoplasias del Cuello Uterino/epidemiologíaRESUMEN
OBJECTIVE: Chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are associated with increased risks of lymphomas in the non-HIV setting. Their impacts on HIV-associated lymphomas deserved further studies in the modern combined antiretroviral therapy (cART) era. DESIGN: We evaluated the associations between HCV, HBV and HIV-related lymphomas in the Lymphovir-ANRS-CO16 cohort. METHODS: Prevalence of HCV seropositivity and chronic HBV infections were compared with those observed in the French Hospital Database on HIV (FHDH-ANRS-CO4). RESULTS: Between 2008 and 2015, 179 patients with HIV-related lymphomas from 32 French hospitals were enrolled, 69 had Hodgkin's lymphoma (39%), and 110 non-Hodgkin's lymphoma (NHL) (61%). The prevalence of HCV infection was higher in patients with NHL than in the FHDH-ANRS-CO4 [26 versus 14%, odd ratio (OR): 2.15; 95% confidence interval (1.35-3.32)] whereas there was no association between Hodgkin's lymphoma and chronic HCV infection. Chronic HBV infection was not associated with NHL in our cohort with a prevalence of 5 versus 7% in FHDH-ANRS-CO4 but tended to be associated with Hodgkin's lymphoma [prevalence of 14%, OR: 2.16 (0.98-4.27)]. Chronic HCV infection tended to pejoratively impact 2-year overall survival in patients with NHL: 72% [57%, 91%] versus 82% [74%, 91%], hazard ratio: 2.14 [0.95-4.84]. In contrast, chronic HBV infection did not correlate with outcome. CONCLUSION: In the modern cART era, chronic HCV infection is associated with an increased risk of NHL in PLWHIV and tends to pejoratively impact overall survival. HBV infection is not associated with the risk of NHL but with a borderline increase of Hodgkin's lymphoma risk.
Asunto(s)
Infecciones por VIH/complicaciones , Hepatitis B Crónica/complicaciones , Hepatitis C Crónica/complicaciones , Linfoma Relacionado con SIDA/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Coinfección , Bases de Datos Factuales , Femenino , Francia , Hepatitis B Crónica/epidemiología , Hepatitis C Crónica/epidemiología , Humanos , Linfoma Relacionado con SIDA/mortalidad , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Adulto JovenRESUMEN
BACKGROUND: Malignant lymphoma is still the leading cause of death among AIDS-related diseases. PATIENTS AND METHODS: We performed a retrospective analysis of 50 HIV-positive lymphoma patients. The median interval between HIV and malignant lymphoma diagnosis was 4 years. Eight patients (16%) had Hodgkin lymphoma and 42 (84%) non-Hodgkin lymphoma. Among non-Hodgkin lymphoma patients, diffuse large B-cell lymphoma (n = 18, 42%), Burkitt lymphoma (n = 11, 26%), and plasmoblastic lymphoma (n = 5, 12%) were the most frequent entities. RESULTS: Lymphoma was treated according to standard protocols. Forty-four patients (88%) received combination antiretroviral therapy, 2 (4%) were not treated, and in 4 (8%) the HIV treatment status was not clarified. Response to first-line therapy was complete response (CR) in 24 (56%), partial response (PR) in 15 (35%), and stable disease in 1 (2%). Three patients (7%) developed progressive disease, and 9 (18%) experienced relapse after CR or PR. At a median observation period of 31 (range, 0.4-192) months, the 1-, 2-, and 5-year overall survival was 87%, 79%, and 76%, respectively. At univariate analysis, remission status after first-line treatment was predictive of outcome, as the 2-year overall survival was 95%, 66%, and 0 for patients with CR, with PR, and with progressive disease (P < .001). Results of the multivariate analysis revealed lactate dehydrogenase concentration at lymphoma diagnosis (P = .046) and relapse (P = .050) to be independent factors for overall survival. CONCLUSION: First-line treatment of lymphoma in HIV positive patients is crucial. Patients who experienced and maintained a first CR had a favorable prognosis.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Antivirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Linfoma Relacionado con SIDA/tratamiento farmacológico , Adolescente , Adulto , Anciano , Niño , Preescolar , Quimioterapia Combinada , Femenino , Infecciones por VIH/complicaciones , Humanos , Lactante , Recién Nacido , Estimación de Kaplan-Meier , Linfoma Relacionado con SIDA/complicaciones , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Pronóstico , Inducción de Remisión , Estudios Retrospectivos , Adulto JovenRESUMEN
INTRODUCTION: HIV-infected patients are more than 100-fold greater at risk for developing malignant AIDS-related lymphoma (ARL) compared to the general population. Most ARLs are EBV related. The main purpose of this study was to investigate whether a high peak EBV DNA load in HIV-infected patients is predictive of ARL, including classical Hodgkin lymphoma. METHODS: From an ongoing prospective HIV positive cohort study, we conducted a case-control study between 2004 and 2016 among patients from whom at least one EBV DNA load in serum or plasma was available. We compared peak EBV DNA load between patients with (49 cases) and without ARL (156 controls). RESULTS: The geometric mean of the peak EBV DNA load measured before diagnosis of malignant lymphoma was 52,565 IU/mL in EBER-positive lymphoma patients vs. 127 IU/mL in controls (p < .001). Patients with EBV DNA loads >100,000 IU/mL have an increased risk for diagnosis of malignant lymphoma compared to patients with EBV DNA loads ≤100,000 IU/mL (adjusted OR 12.53; 95%CI: 4.08; 38.42). In the longitudinal study, including 13 patients with at least three left-over plasma samples available for retesting, measurements of EBV-DNA during the preceding 12 months proved to be of poor value for predicting subsequent lymphoma diagnosis. CONCLUSIONS: A EBV DNA load >100,000 IU/mL can be useful in clinical setting to accelerate time to diagnosis and treatment. EBV-DNA loads in samples taken during the preceding year of ARL diagnosis showed to be of poor predictive value.
Asunto(s)
ADN Viral/sangre , Infecciones por Virus de Epstein-Barr/virología , Infecciones por VIH/complicaciones , Herpesvirus Humano 4/aislamiento & purificación , Linfoma Relacionado con SIDA/diagnóstico , Adulto , Estudios de Casos y Controles , Estudios de Cohortes , Estudios Transversales , Infecciones por Virus de Epstein-Barr/complicaciones , Femenino , Infecciones por VIH/virología , Herpesvirus Humano 4/genética , Humanos , Estudios Longitudinales , Linfoma Relacionado con SIDA/complicaciones , Linfoma Relacionado con SIDA/virología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Riesgo , Carga ViralAsunto(s)
Ganglios Linfáticos/patología , Linfoma Relacionado con SIDA/patología , Linfoma de Efusión Primaria/patología , Adulto , Biomarcadores de Tumor/análisis , Diagnóstico Diferencial , Infecciones por Virus de Epstein-Barr/virología , Hepatitis C Crónica/complicaciones , Infecciones por Herpesviridae/virología , Herpesvirus Humano 4/aislamiento & purificación , Herpesvirus Humano 8/aislamiento & purificación , Humanos , Inmunofenotipificación , Ganglios Linfáticos/virología , Linfoma Relacionado con SIDA/complicaciones , Linfoma Relacionado con SIDA/diagnóstico , Linfoma Relacionado con SIDA/virología , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma de Efusión Primaria/complicaciones , Linfoma de Efusión Primaria/diagnóstico , Linfoma de Efusión Primaria/virología , Masculino , Proteínas Virales/análisisRESUMEN
BACKGROUND: We report the first case to our knowledge of a patient with relapsed/refractory classical hodgkin lymphoma and liver failure with encephalopathy along with human immunodeficiency virus/acquired immunodeficiency syndrome infection, successfully treated with nivolumab without major side effects and encouraging prolonged disease control. CASE PRESENTATION: In December 2015, at the time of the patient's progression from his Hodgkin lymphoma after fourth line treatment, he developed persistent fevers, abdominal distension, jaundice and worsening of his liver function tests. Magnetic resonance imaging of abdomen/pelvis demonstrated hepatomegaly with innumerable new liver lesions, splenomegaly with multiple splenic nodules and several new mediastinal, intraperitoneal and retroperitoneal lymphadenopathy. In accordance with the patient's wishes before admission, and after agreement with the family, nivolumab (3 mg/kg every 2 weeks) was given. Of note, antiretroviral therapy was on hold due to liver function tests, his viral load was undectable and cluster of differentiation 4 counts were 103/uL at the time of nivolumab administration. One week after the first dose of nivolumab both his hepatic encephalopathy and constitutional symptoms started to improve, and after 2 doses, (January 2016) his LFTs were almost back to normal. After 5 months of nivolumab treatment (10 doses), restaging (computerized tomography scans of neck, chest, abdomen, pelvis) done on May 2016 showed resolution of hepatosplenomegaly with two residual small hepatic lesions, heterogeneous spleen with no splenic lesions, and stable non-enlarged retroperitoneal lymph nodes without intraabdominal lymphadenopathy; consistent with partial response. CONCLUSIONS: We report a case of a patient with human immunodeficiency virus/acquired immunodeficiency syndrome -related relapsed/refractory classical Hodgkin lymphoma and acute liver failure with encephalopathy successfully treated with nivolumab after failing all standard therapeutic options. Unlike classic cytotoxic chemotherapy, which relies on preserved organ function to ameliorate potential severe side effects (i.e. myelosuppression), elimination of monoclonal antibodies is fairly independent of baseline renal and hepatic function since they are usually metabolized by circulating phagocytes and/or by their target antigen-expressing cell.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Antineoplásicos/uso terapéutico , Encefalopatía Hepática/tratamiento farmacológico , Enfermedad de Hodgkin/tratamiento farmacológico , Linfoma Relacionado con SIDA/tratamiento farmacológico , Adulto , Encefalopatía Hepática/etiología , Enfermedad de Hodgkin/complicaciones , Humanos , Linfoma Relacionado con SIDA/complicaciones , Masculino , Nivolumab , Terapia Recuperativa/métodosRESUMEN
Plasmablastic lymphoma is a rare and aggressive B cell lymphoma that is considered to be strongly associated with HIV infection. This article explores the histological morphology and immunohistochemical characteristics of HIV/AIDS-related plasmablastic lymphoma with the goal of improving the diagnosis and treatment of this rare tumor. According to criteria of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (2008), six plasmablastic lymphoma cases admitted to the Shanghai Public Health Clinical Center were comprehensively analyzed with conventional hematoxylin-eosin staining, immunohistochemical staining and in situ hybridization. The morphological features of six tumors were consistent with PBL. Immunohistochemical staining showed that all six cases were negative for CD19, CD20, and CD79a, and positive for OCT-2, BOB-1, VS38c, and melanoma ubiquitous mutated 1. The Ki67 proliferation index was higher than 90% in all six cases. In situ hybridization indicated that four cases were EBER-positive. In addition, three cases had C-MYC translocation rearrangement. Our results showed that the immunophenotypes of PBL vary, which makes PBL diagnosis difficult. Therefore, morphological characteristics, immunophenotypic markers, and clinical data should be used in combination to enable an accurate diagnosis, especially in the presence of immunophenotypic variation, as this approach will facilitate timely treatment.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Infecciones por VIH/complicaciones , Linfoma Relacionado con SIDA/diagnóstico , Linfoma Plasmablástico/diagnóstico , Adulto , China/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Inmunofenotipificación , Hibridación in Situ , Linfoma Relacionado con SIDA/complicaciones , Linfoma Relacionado con SIDA/patología , Masculino , Persona de Mediana Edad , Linfoma Plasmablástico/complicaciones , Linfoma Plasmablástico/patologíaRESUMEN
Classically, the HIV/AIDS-related lymphomas are of the B cell type and involve the central nervous system and the abdominal cavity. Primary maxillary sinus lymphoma is rare. Plasmablastic lymphoma (PBL) is an aggressive form of non-Hodgkinvs lymphoma, and is extremely rare. Here we present a case of plasmablastic lymphoma with primary site being maxillary sinus, a rare location.
Asunto(s)
Infecciones por VIH/complicaciones , Linfoma Relacionado con SIDA/patología , Neoplasias Maxilares/patología , Seno Maxilar/diagnóstico por imagen , Mucosa Bucal/patología , Linfoma Plasmablástico/patología , Tomografía Computarizada por Rayos X/métodos , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biopsia , Ciclofosfamida , Doxorrubicina , Infecciones por VIH/patología , VIH-1 , Humanos , Linfoma Relacionado con SIDA/complicaciones , Linfoma Relacionado con SIDA/tratamiento farmacológico , Masculino , Mandíbula/diagnóstico por imagen , Neoplasias Maxilares/virología , Linfoma Plasmablástico/complicaciones , Linfoma Plasmablástico/tratamiento farmacológico , Prednisona , Radiografía Panorámica , Resultado del Tratamiento , VincristinaRESUMEN
Central nervous system (CNS) involvement is reportedly more common in acquired immunodeficiency syndrome (AIDS)-related lymphomas (ARL). We describe factors and outcomes associated with CNS involvement at baseline (CNS(B) ) and relapse (CNS(R) ) in 886 patients with newly diagnosed ARL. Of 886 patients, 800 received either intrathecal (IT) therapy for CNS(B) or IT prophylaxis. CNS(B) was found in 13%. CNS(B) was not associated with reduced overall survival (OS). There was no difference in the prevalence of CNS(B) between the pre-combination antiretroviral therapy (cART) and cART eras. 5·3% of patients experienced CNS(R) at a median of 4·2 months after diagnosis (12% if CNS(B) ; 4% if not). Median OS after CNS(R) was 1·6 months. On multivariate analysis, only CNS(B) [hazard ratio (HR) 3·68, P = 0·005] and complete response to initial therapy (HR 0·14, P < 0·0001) were significantly associated with CNS(R) . When restricted to patients without CNS(B) , IT CNS prophylaxis with 3 vs. 1 agent did not significantly impact the risk of CNS(R) . Despite IT CNS prophylaxis, 5% of patients experienced CNS(R) . Our data confirms that CNS(R) in ARL occurs early and has a poor outcome. Complete response to initial therapy was associated with a reduced frequency of CNS(R) . Although CNS(B) conferred an increased risk for CNS(R) , it did not impact OS.
Asunto(s)
Neoplasias del Sistema Nervioso Central/etiología , Linfoma Relacionado con SIDA/complicaciones , Adolescente , Adulto , Anciano , Antirretrovirales/uso terapéutico , Neoplasias del Sistema Nervioso Central/mortalidad , Neoplasias del Sistema Nervioso Central/terapia , Bases de Datos Factuales , Femenino , Humanos , Linfoma Relacionado con SIDA/tratamiento farmacológico , Linfoma Relacionado con SIDA/mortalidad , Masculino , Persona de Mediana Edad , Premedicación , Recurrencia , Inducción de Remisión/métodos , Tasa de Supervivencia , Resultado del Tratamiento , Adulto JovenAsunto(s)
Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Terapia Antirretroviral Altamente Activa , Linfoma Relacionado con SIDA/tratamiento farmacológico , Linfoma Plasmablástico/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Adolescente , Adulto , Fármacos Anti-VIH/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Humanos , Linfoma Relacionado con SIDA/complicaciones , Persona de Mediana Edad , Linfoma Plasmablástico/complicaciones , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del Tratamiento , Adulto JovenAsunto(s)
Linfoma de Burkitt/diagnóstico , Neoplasias Renales/diagnóstico , Linfoma Relacionado con SIDA/diagnóstico , Lesión Renal Aguda/etiología , Adulto , Linfoma de Burkitt/complicaciones , Infecciones por Virus de Epstein-Barr/complicaciones , Resultado Fatal , Humanos , Neoplasias Renales/complicaciones , Linfoma Relacionado con SIDA/complicaciones , MasculinoAsunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Neoplasias del Sistema Nervioso Central/complicaciones , VIH/patogenicidad , Síndrome Inflamatorio de Reconstitución Inmune/etiología , Linfoma Relacionado con SIDA/complicaciones , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/patología , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/patología , Quimioterapia Combinada , Humanos , Síndrome Inflamatorio de Reconstitución Inmune/tratamiento farmacológico , Síndrome Inflamatorio de Reconstitución Inmune/patología , Linfoma Relacionado con SIDA/tratamiento farmacológico , Linfoma Relacionado con SIDA/patología , Masculino , Persona de Mediana Edad , PronósticoAsunto(s)
Acidosis Láctica/etiología , Infecciones por Virus de Epstein-Barr/complicaciones , Linfoma Relacionado con SIDA/complicaciones , Linfoma de Células B Grandes Difuso/complicaciones , Adulto , Infecciones por Virus de Epstein-Barr/patología , Humanos , Linfoma Relacionado con SIDA/patología , Linfoma de Células B Grandes Difuso/patología , MasculinoAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfohistiocitosis Hemofagocítica/etiología , Linfoma Relacionado con SIDA/diagnóstico , Linfoma de Efusión Primaria/diagnóstico , Corticoesteroides/uso terapéutico , Adulto , Fármacos Anti-VIH/uso terapéutico , Anticuerpos Monoclonales de Origen Murino/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Ciclofosfamida/administración & dosificación , Citarabina/administración & dosificación , Diagnóstico por Imagen , Doxorrubicina/administración & dosificación , Diagnóstico Precoz , Infecciones por Virus de Epstein-Barr/complicaciones , Etopósido/administración & dosificación , Infecciones por Herpesviridae/complicaciones , Infecciones por Herpesviridae/virología , Herpesvirus Humano 8/aislamiento & purificación , Humanos , Linfohistiocitosis Hemofagocítica/tratamiento farmacológico , Linfoma Relacionado con SIDA/complicaciones , Linfoma Relacionado con SIDA/tratamiento farmacológico , Linfoma de Efusión Primaria/complicaciones , Linfoma de Efusión Primaria/tratamiento farmacológico , Masculino , Metotrexato/administración & dosificación , Prednisona/administración & dosificación , Inducción de Remisión , Rituximab , Vincristina/administración & dosificación , Viremia/complicacionesRESUMEN
Hodgkin lymphoma (HL) is more frequent in patients with Human Immunodeficiency Virus (HIV) infection than in immunocompetent patients. The relationship between the immune system and HL is complex. Whilst the incidence of HL in HIV patients has most likely increased since the introduction of combined anti-retroviral therapy (cART), there is no doubt that the outcomes for patients with HIV and HL (HIV-HL) have improved since its introduction. Improved CD4 counts and risk-adapted treatment schedules have resulted in outcomes for patients with HIV-HL that are comparable to those in HIV-negative patients with HL. Thus, HIV-HL should be treated in the same way as HL in immunocompetent patients, including the use of salvage chemotherapy and autologous transplant in the relapsed setting in HIV-HL. Along the same lines, patients with HIV-HL should not be excluded from trials based on their immune status alone.