Combined chemotherapy including high-dose methotrexate in KSHV/HHV8-associated primary effusion lymphoma.
Am J Hematol
; 73(3): 143-8, 2003 Jul.
Article
in En
| MEDLINE
| ID: mdl-12827649
ABSTRACT
Primary effusion lymphoma (PEL) is a rare KSHV/HHV8-associated high-grade non-Hodgkin's lymphoma (NHL) of B-cell origin, characterized by serous effusions in body cavities. Most patients are HIV-infected homosexual men with severe immunosuppression and other KSHV/HHV8-associated diseases such as Kaposi's sarcoma (KS). The prognosis is poor with a median survival of less than 6 months in most cohorts. The achievement of a sustained complete remission is rare. High-dose chemotherapy regimens are warranted to improve complete remission rate and survival. Seven patients with AIDS-associated PEL were treated with a combined chemotherapy including high-dose methotrexate followed by leucovorin rescue. In all cases, KSHV/HHV8 sequences were detected in the effusion samples using quantitative PCR assays. Five patients had a pre-existing KS, associated in three cases with multicentric Castleman's disease (MCD). Upon diagnosis, 6 patients received antiretroviral therapy, which was maintained during chemotherapy in 5 of them. At time of analysis, 3 out of 7 patients were in complete remission 18, 26, and 78 months after PEL diagnosis. Three patients died with a progressive PEL at 22, 67, and 153 days after diagnosis, and 1 patient died 9 months after PEL diagnosis with a MCD-associated plasmablastic NHL. Complete remission was obtained in 3 out of 7 patients treated for AIDS-associated PEL with combined chemotherapy containing high-dose methotrexate.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sarcoma, Kaposi
/
Antineoplastic Combined Chemotherapy Protocols
/
Methotrexate
/
Acquired Immunodeficiency Syndrome
/
Herpesviridae Infections
/
Herpesvirus 8, Human
/
Antiretroviral Therapy, Highly Active
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Am J Hematol
Year:
2003
Document type:
Article
Affiliation country: