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Zhuang K, Zhang Y, Mo P, Deng L, Jiang Y, Yu L, Mei F, Huang S, Chen X, Yan Y, Tang H, Li X, Xiong Y, Wu S, Ke H, Gui X, Lan K. Plasma proteomic analysis reveals altered protein abundances in HIV-infected patients with or without Non-Hodgkin Lymphoma. J Med Virol 2022; 94:3876-3889. [PMID: 35415847 DOI: 10.1002/jmv.27775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 11/07/2022]
Abstract
The identification of circulating proteins associated with acquired immunodeficiency syndrome-related non-Hodgkin lymphoma (AIDS-NHL) may help in the development of promising biomarkers for screening, diagnosis, treatment and prognosis. Here, we used quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs) in plasma collected from patients with AIDS-NHL and human immunodeficiency virus (HIV)-infected patients without NHL (HIV+ ). Proteins with a log2 (fold change) in abundance >0.26 and p value less than 0.05 (p < 0.05) were considered differentially abundant. In total, 84 DEPs were identified, among which 20 were further validated as potential biomarkers, with immunoglobulin and complement components being the most common proteins. Some of the proteins were further verified in a retrospective analysis of the medical records of patients in a larger cohort. These markedly altered proteins were found to mediate pathophysiological pathways that likely contribute to AIDS-NHL pathogenesis, such as the humoral immune response, complement activation, and complement and coagulation cascades. Our findings provide a new molecular understanding of AIDS-NHL pathogenesis and provide new evidence supporting the identification of these proteins as possible biomarkers in AIDS-NHL. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ke Zhuang
- ABSL-III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
| | - Yongxi Zhang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Pingzheng Mo
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Liping Deng
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yong Jiang
- State Key Laboratory of Virology, Modern Virology Research Center, College of Life Sciences, Wuhan University, Wuhan, Hubei, P. R. China
| | - Lei Yu
- State Key Laboratory of Virology, Modern Virology Research Center, College of Life Sciences, Wuhan University, Wuhan, Hubei, P. R. China
| | - Fanghua Mei
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Shaoxin Huang
- SpecAlly Life Technology Co., Ltd., Wuhan, Hubei, China
| | - Xi Chen
- SpecAlly Life Technology Co., Ltd., Wuhan, Hubei, China
| | - Yajun Yan
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hongbin Tang
- ABSL-III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
| | - Xiangdong Li
- ABSL-III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
| | - Yong Xiong
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Shuwen Wu
- State Key Laboratory of Virology, Modern Virology Research Center, College of Life Sciences, Wuhan University, Wuhan, Hubei, P. R. China
| | - Hengning Ke
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xien Gui
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ke Lan
- ABSL-III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China.,State Key Laboratory of Virology, Modern Virology Research Center, College of Life Sciences, Wuhan University, Wuhan, Hubei, P. R. China
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Rituximab plus concurrent infusional EPOCH chemotherapy is highly effective in HIV-associated B-cell non-Hodgkin lymphoma. Blood 2009; 115:3008-16. [PMID: 20023215 DOI: 10.1182/blood-2009-08-231613] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Rituximab plus intravenous bolus chemotherapy is a standard treatment for immunocompetent patients with B-cell non-Hodgkin lymphoma (NHL). Some studies have suggested that rituximab is associated with excessive toxicity in HIV-associated NHL, and that infusional chemotherapy may be more effective. We performed a randomized phase 2 trial of rituximab (375 mg/m(2)) given either concurrently before each infusional etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone (EPOCH) chemotherapy cycle or sequentially (weekly for 6 weeks) after completion of all chemotherapy in HIV-associated NHL. EPOCH consisted of a 96-hour intravenous infusion of etoposide, doxorubicin, and vincristine plus oral prednisone followed by intravenous bolus cyclophosphamide given every 21 days for 4 to 6 cycles. In the concurrent arm, 35 of 48 evaluable patients (73%; 95% confidence interval, 58%-85%) had a complete response. In the sequential arm, 29 of 53 evaluable patients (55%; 95% confidence interval, 41%-68%) had a complete response. The primary efficacy endpoint was met for the concurrent arm only. Toxicity was comparable in the 2 arms, although patients with a baseline CD4 count less than 50/microL had a high infectious death rate in the concurrent arm. We conclude that concurrent rituximab plus infusional EPOCH is an effective regimen for HIV-associated lymphoma.
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Martí-Carvajal AJ, Cardona AF, Lawrence A. Interventions for previously untreated patients with AIDS-associated non-Hodgkin's lymphoma. Cochrane Database Syst Rev 2009:CD005419. [PMID: 19588373 DOI: 10.1002/14651858.cd005419.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection is known to be associated with an increased risk of non-Hodgkin's lymphoma (NHL). The majority of lymphomas (>80%) occurring during immunosuppression are aggressive B-cell in origin and have a high-to-intermediate histology grade. Treatment of NHL is not standardized. OBJECTIVES To assess the clinical effectiveness and safety of single agent or combination chemotherapy with or without immunochemotherapy (rituximab) and with or without highly active antiretroviral therapy (HAART) on overall survival (OS) and disease-free survival (DFS) for previously untreated patients with AIDS-related NHL. SEARCH STRATEGY The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2009), MEDLINE (1966-March 6, 2009), EMBASE (1988-March 6, 2009), LlLACS (1982 to February 17, 2009), Gateway (March 6, 2009), and AIDSearch (2006 -February 2008) were used to identify published, potentially eligible trials. Further, we searched several electronic sources. For additional information see the Cochrane HIV/AIDS Group search strategy. SELECTION CRITERIA Randomized controlled trials (RCTs) assessing the effectiveness of systemic treatments for previously untreated AIDS-related NHL. There were no age or language restrictions. DATA COLLECTION AND ANALYSIS Authors independently assessed relevant studies for inclusion; four RCTs were selected. No meta-analysis was attempted due to clinical heterogeneity. MAIN RESULTS Four RCTs that included 857 patients (number range: 30 to 485) met the inclusion criteria. The studies have a high risk of bias; three RCTs were conducted in the United States and one was a multi-national, multi-centre RCT performed in France and Italy. One of the trials included only men. It was impossible to pool data for any of the outcomes due to the differences in the interventions assessed in these RCTs. Overall survival did not differ significantly between treatment groups. Disease free survival (DFS) was reported in two of the four RCTs, but it was not statistically significant between treatment groups. AUTHORS' CONCLUSIONS We found no evidence that the systemic interventions for untreated patients with AIDS-related NHL provide superior clinical effectiveness for improving OS, DSF, and tumour response rate; however, this conclusion is based on four RCTs with limited sample size and variable quality. More adequately powered RCTs that have low risk of bias are necessary to determine the real benefit or harm of interventions to treat this population. Overall survival (OS), DFS, and quality of life should be included as endpoints.
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Angeletti PC, Zhang L, Wood C. The viral etiology of AIDS-associated malignancies. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2008; 56:509-57. [PMID: 18086422 DOI: 10.1016/s1054-3589(07)56016-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Peter C Angeletti
- Nebraska Center for Virology, School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska 68588, USA
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Resino S, Pérez A, Seoane E, Serrano D, Berenguer J, Balsalobre P, Goméz-Chacon GF, Díez-Martin JL, Muñoz-Fernández MA. Short communication: Immune reconstitution after autologous peripheral blood stem cell transplantation in HIV-infected patients: might be better than expected? AIDS Res Hum Retroviruses 2007; 23:543-8. [PMID: 17506611 DOI: 10.1089/aid.2006.0071] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We carried out a longitudinal study to analyze the immune recovery of four patients with aggressive HIV-associated lymphoma (HIV+ Ly+) treated with highly active antiretroviral therapy (HAART) and high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT). We also studied three control non-HIV-infected patients with lymphoma (HIV-Ly+) and six HIV patients on HAART without lymphoma (HIV+ Ly-). After 12 months of follow-up, the HIV HIV+Ly+ patients reached the pre-ASCT CD4+ levels, despite a transient decrease after the ASCT. All ASCT patients (HIV+Ly+ and HIV-Ly+) showed an increase in CD4+, CD4+ CD45RO+, and CD4+CD28+ T cells/microl. Although HIV+Ly+ patients had values of CD4+, CD4+CD45RO+, and CD4+CD28+ T cells/microl lower than the HIV-Ly+ patients, their recovery rate over the 12 months after ASCT appeared to be better. HIV+Ly+ patients had higher pre-ASCT plasma IL-7 levels than HIV-Ly+, however, these values decreased after ASCT. All ASCT patients showed a slight increase of TCR rearrangement excision circles (TRECs) and they did not have a different pattern of TREC evolution. We could not find differences between HIV+Ly+ patients 12 months after ASCT and HIV+Ly- in DNA-HIV (copies/10(6) cell). Overall, HIV+Ly+ patients showed an appropriate immune reconstitution 12 months after ASCT, and, interestingly, they had an amount of DNA-HIV copies similar to HIV+Ly- control patients in their CD4+ cells.
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Affiliation(s)
- Salvador Resino
- Laboratorio de Inmuno-Biología Molecular, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo 46, 28007 Madrid, Spain.
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Mounier N, Spina M, Gisselbrecht C. Modern management of non-Hodgkin lymphoma in HIV-infected patients. Br J Haematol 2007; 136:685-98. [PMID: 17229246 DOI: 10.1111/j.1365-2141.2006.06464.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patients infected with human immunodeficiency virus (HIV) are at greater risk of developing non-Hodgkin lymphoma than the general population and aggressive B-cell lymphoma has become one of the most common of the initial acquired immunodeficiency syndrome (AIDS)-defining illnesses. This review considers the prognostic factors and new approaches to the treatment of patients with AIDS-related lymphoma (ARL). As highly active antiretroviral therapy (HAART) became available, the survival of many ARL patients has become comparable to that of HIV-negative patients. This is partly due to the decrease in the incidence of opportunistic infections and improved prognosis. Both developments can also be attributed to new treatment strategies for ARL, such as the use of effective infusional regimens, Rituximab combinations and high-dose therapy with autologous stem-cell transplantation for relapsed disease. However, unresolved issues persist, such as the optimal therapy for patients with Burkitt ARL or central nervous system involvement.
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Affiliation(s)
- Nicolas Mounier
- Groupe d'Etude des Lymphomes de l'Adulte, GELA, 1 av C Vellefaux, Paris, France.
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Primary central nervous system lymphoma. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s0072-9752(07)85015-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Mounier N, Spina M, Gabarre J, Raphael M, Rizzardini G, Golfier JB, Vaccher E, Carbone A, Coiffier B, Chichino G, Bosly A, Tirelli U, Gisselbrecht C. AIDS-related non-Hodgkin lymphoma: final analysis of 485 patients treated with risk-adapted intensive chemotherapy. Blood 2006; 107:3832-40. [PMID: 16410446 DOI: 10.1182/blood-2005-09-3600] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We aimed to compare AIDS risk–adapted intensive chemotherapy in AIDS-related lymphoma (ARL) patients before and after the advent of highly active antiretroviral therapy (HAART). A total of 485 patients aged from 18 to 67 years were randomly assigned to chemotherapy after stratification according to an HIV score based on performance status, prior AIDS, and CD4+ cell counts below 0.10 × 109/L (100/mm3). A total of 218 good-risk patients (HIV score 0) received ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisolone) or CHOP (doxorubicin, cyclophosphamide, vincristine, and prednisolone); 177 intermediate-risk patients (HIV score 1), CHOP or low-dose CHOP (Ld-CHOP); and 90 poor-risk patients (HIV score 2-3), Ld-CHOP or VS (vincristine and steroid). The 5-year overall survival (OS) in the good-risk group was 51% for ACVBP versus 47% for CHOP (P = .85); in the intermediate-risk group, 28% for CHOP versus 24% for Ld-CHOP (P = .19); and in the poor-risk group, 11% for Ld-CHOP versus 3% for VS (P = .14). The time-dependent Cox model demonstrated that the only significant factors for OS were HAART (relative risk [RR] 1.6, P < .001), HIV score (RR 1.7, P < .001), and the International Prognostic Index (IPI) score (RR 1.5, P < .001) but not chemotherapy regimen. Our findings indicate that in ARL patients, HIV score, IPI score, and HAART affect survival but not the intensity of the CHOP-based chemotherapy.
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Affiliation(s)
- Nicolas Mounier
- Institut Universitaire d'Hématologie-GELA, INSERM U728-Hôpital Saint Louis-AP-HP-1, Avenue Claude Vellefaux, 75010 Paris, France.
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Malhotra P, Shah SS, Kaplan M, McGowan JP. Cryptococcal fungemia in a neutropenic patient with AIDS while receiving caspofungin. J Infect 2005; 51:e181-3. [PMID: 16230203 DOI: 10.1016/j.jinf.2005.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2004] [Accepted: 01/04/2005] [Indexed: 01/21/2023]
Abstract
Empiric choice of anti-fungal therapy in febrile neutropenia should be based upon a host's susceptibility to specific fungal pathogens. We present a case of a patient with multiple risk factors for fungemia including HIV infection, Hodgkin's disease, corticosteroid use and chemotherapy-induced neutropenia who developed disseminated cryptococcal infection while receiving caspofungin.
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Martí-Carvajal AJ, Munoz SR. Interventions for treating AIDS-associated Non-Hodgkin´s Lymphoma (NHL) in treatment-naive adults with AIDS. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2005. [DOI: 10.1002/14651858.cd005419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Piriou E, Jansen CA, van Dort K, De Cuyper I, Nanlohy NM, Lange JMA, van Oers MHJ, Miedema F, van Baarle D. Reconstitution of EBV Latent but Not Lytic Antigen-Specific CD4+and CD8+T Cells after HIV Treatment with Highly Active Antiretroviral Therapy. THE JOURNAL OF IMMUNOLOGY 2005; 175:2010-7. [PMID: 16034146 DOI: 10.4049/jimmunol.175.3.2010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The incidence of (EBV-related) malignancies in HIV-infected subjects has declined since the introduction of highly active antiretroviral therapy (HAART). To investigate the effect of HAART on EBV infection, we performed a longitudinal analysis of the T cell response to both a latent and a lytic Ag and EBV viral load in 10 subjects from early in HIV infection up to 5 years after HAART. All individuals responded to HAART by a decline in HIV viral load, a restoration of total CD4+ T cell numbers, and a decline in T cell immune activation. Despite this, EBV load remained unaltered, even after 5 years of therapy, although a decline in both CD4+ and CD8+ T cells specific for the lytic EBV protein BZLF1 suggested a decreased EBV reactivation rate. In contrast, latent EBV Ag EBNA1-specific CD4+ and CD8+ T cell responses were restored after 5 years of treatment to levels comparable to healthy individuals. In two individuals who were treated by HAART late during HIV progression, a lymphoma developed shortly after initiation of HAART, despite restoration of EBV-specific CD4+ and CD8+ T cells. In conclusion, long-term HAART does not alter the EBV DNA load, but does lead to a restoration of EBNA1-specific T cell responses, which might allow better control of EBV-infected cells when applied early enough during HIV infection.
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Affiliation(s)
- Erwan Piriou
- Department of Clinical Viro-Immunology, Sanquin Research at CLB and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Coupland SE, Charlotte F, Mansour G, Maloum K, Hummel M, Stein H. HHV-8-Associated T-Cell Lymphoma in a Lymph Node With Concurrent Peritoneal Effusion in an HIV-Positive Man. Am J Surg Pathol 2005; 29:647-52. [PMID: 15832089 DOI: 10.1097/01.pas.0000157937.01624.1d] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Primary effusion lymphoma (PEL) is an uncommon large cell lymphoma, usually seen in human immunodeficiency virus (HIV)-infected patients. PEL is characterized by various clinical, histomorphologic, and immunophenotypical features, and is associated with the human herpes virus 8 (HHV-8). PEL may present as either a body cavity-based lymphomatous effusion or a solid tumor mass. Most so-called "solid PEL" usually have an extranodal location; exceptionally rarely, they occur in lymph nodes. The majority of PEL consist of malignant cells of B-cell genotype; seldom they are of T-cell origin. We report a rare case of HHV-8-associated "solid PEL" of T-cell type in a 41-year-old HIV-seropositive man with a concomitant peritoneal effusion. The T-cell lymphoma was diagnosed on the basis of morphologic, immunophenotypic, and molecular findings of a lymph node biopsy. The tumor cells strongly expressed CD45R0, CD7, CD43, MUM1/IRF4, CD30, HHV-8, and EBER, and demonstrated a clonal rearrangement of T-cell receptor-gamma chain gene. The following case provides another example of a lymph node-based "solid" PEL, demonstrating the variety within the spectrum of HHV-8-associated lymphoma.
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MESH Headings
- Adult
- Ascitic Fluid/pathology
- Biomarkers, Tumor/analysis
- Clone Cells
- Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor
- HIV Seropositivity
- Herpesviridae Infections/complications
- Herpesviridae Infections/metabolism
- Herpesviridae Infections/pathology
- Herpesvirus 8, Human/isolation & purification
- Herpesvirus 8, Human/physiology
- Humans
- Lymph Nodes/metabolism
- Lymph Nodes/pathology
- Lymphoma, T-Cell, Peripheral/metabolism
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoma, T-Cell, Peripheral/virology
- Male
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Affiliation(s)
- Sarah E Coupland
- Department of Pathology, Charité-University Medicine, Campus Benjamin Franklin, Berlin, Germany.
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Abstract
PURPOSE OF REVIEW Infection with human immunodeficiency virus (HIV) is associated with an increased risk of non-Hodgkin lymphoma and Hodgkin disease. This review summarizes developments within the past 18 months. RECENT FINDINGS Investigators continue to demonstrate that many standard therapies similar to those used in the non-HIV- infected population may be used in the HAART era for patients infected with HIV. Biologic differences do exist, however, and not all treatments and outcomes are directly translatable. Some treatments, such as rituximab in combination with CHOP, may have unforeseen toxicity. Nonetheless, high-dose therapy does appear feasible and may offer curative therapy for those with refractory and relapsed disease. SUMMARY HIV-infected persons appear to benefit from most, but not all standard treatments for lymphoma.
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Affiliation(s)
- Ariela Noy
- Division of Hematology, Memorial Sloan-Kettering Cancer, Weill Medical College of Cornell University, New York, New York 10021, USA.
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