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Huguet M, Navarro JT, Moltó J, Ribera JM, Tapia G. Diffuse Large B-Cell Lymphoma in the HIV Setting. Cancers (Basel) 2023; 15:3191. [PMID: 37370801 DOI: 10.3390/cancers15123191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Despite the widespread use of combined antiretroviral therapy (cART) and the subsequent decrease in AIDS-defining cancers, HIV-related lymphomas remain a leading cause of morbidity and mortality in people with HIV (PWH). Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma (NHL) subtype in PWH. This lymphoma is a heterogeneous disease including morphological variants and molecular subtypes according to the cell of origin or the mutation profile. In the pre-cART era, treatment with standard-dose chemotherapy induced high rates of toxicity and outcomes were very poor. The introduction of cART and the incorporation of infection prophylaxis allowed the use of conventional intensive chemotherapy regimens used in the general population, such as R-CHOP or R-EPOCH. The use of cART during chemotherapy treatment was initially controversial due to the potential risk of adverse drug-drug interactions. However, the availability of current cART regimens with less potential to cause drug interactions and evidence that cART improves survival rates in NHL strongly support the use of cART in PWH with DLBCL. Consequently, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PWH with NHL.
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Affiliation(s)
- Maria Huguet
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - José-Tomás Navarro
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - José Moltó
- Fundació Lluita Contra les Infeccions, Infectious Diseases Department, Germans Trias i Pujol University Hospital, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
| | - Josep-Maria Ribera
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - Gustavo Tapia
- Department of Pathology, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
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Primary central nervous system lymphoma in patients with and without HIV infection: a multicenter study and comparison with U.S national data. Cancer Causes Control 2019; 30:477-488. [PMID: 30888569 DOI: 10.1007/s10552-019-01144-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/11/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Primary central nervous system lymphoma (PCNSL) in patients living with HIV (PLWH) is a distinct entity; however, the management is adopted from patients without HIV. The study aims to examine the differences in presentation, treatment, and outcomes of PCNSL patients with or without HIV. METHODS We retrospectively compared the characteristics of 144 patients with PCNSL with and without HIV, and analyzed factors associated with overall and progression-free survival. Results were compared to the Central Brain Tumor Registry of the United States (CBTRUS) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) system. RESULTS Among all patients with PCNSL, 19% had HIV. PLWH were younger (38 vs. 63 years; p < 0.01) and more likely to be African American (59% vs. 7%; p < 0.01) and male (74% vs. 49%; p = 0.02) than patients without HIV. PLWH were more likely to have multiple lesions (67% vs. 43%; p = 0.02), hemorrhage (59 vs. 37%; p = 0.03), and peripheral rim enhancement (57% vs. 7%; p < 0.01) on imaging; to receive palliative care (15% vs. 2%) or whole brain radiation (63% vs. 3%); and less likely to receive chemotherapy (22% vs. 95%) (p < 0.01). Twenty-four patients, none PLWH, underwent stem cell transplant. Not receiving transplant was an independent factor in mortality and disease progression. Our cohort of patients, compared to the national database, were younger (60 vs. 65 years), 58% were white vs. 75%, and had longer median overall survival 43 vs. 25 months. CONCLUSION Epidemiology, imaging, and treatment options for patients with PCNSL with and without HIV differ, but HIV was not an independent factor of mortality or disease progression. More efforts are needed to improve access to research and treatment options for PLWH with PCNSL.
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Lim DH, Rhee JY, Park KW. Stage IV advanced diffuse large B-cell lymphoma in human immunodeficiency virus infection with achieving cure by using highly active antiretroviral therapy alone: a case report. Int J STD AIDS 2017; 28:932-936. [PMID: 28094666 DOI: 10.1177/0956462416686512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
After the introduction of highly active antiretroviral therapy (HAART), there has been a decrease in the incidence of lymphoma among the HIV-infected population and also significantly improved survival rates. We describe a remarkable case of an HIV-infected patient with advanced stage IV diffuse large B-cell lymphoma (DLBCL), completely regressed with the use of HAART alone. He remained disease-free for 6 years and he achieved cure without chemotherapy. Although several cases of low-grade lymphoma with complete regression were reported, we could not find any case of stage IV high-grade malignant lymphoma with HAART alone in complete remission for over 5 years from our review of the literature. This unique case shows the importance of HAART in improving survival and achieving cure in HIV-high-grade malignant lymphoma.
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Affiliation(s)
- Do Hyoung Lim
- 1 Division of Hematology-Oncology, Department of Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Ji-Young Rhee
- 2 Division of Infectious Diseases, Department of Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Keon Woo Park
- 1 Division of Hematology-Oncology, Department of Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea
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4
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Brentlinger PE, Silva WP, Vermund SH, Valverde E, Buene M, Moon TD. Practical Management of HIV-Associated Anemia in Resource-Limited Settings: Prospective Observational Evaluation of a New Mozambican Guideline. AIDS Res Hum Retroviruses 2016; 32:12-25. [PMID: 26178574 DOI: 10.1089/aid.2015.0030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Mozambique's updated guideline for management of HIV-associated anemia prompts clinicians to consider opportunistic conditions, adverse drug reactions, and untreated immunosuppression in addition to iron deficiency, intestinal helminthes, and malaria. We prospectively evaluated this guideline in rural Zambézia Province. Likely cause(s) of anemia were determined through prespecified history, physical examination, and laboratory testing. Diagnoses were "etiologic" if laboratory confirmed (sputum microscopy, blood culture, Plasmodium falciparum malaria rapid test) or "syndromic" if not. To assess hemoglobin response, we used serial point-of-care measurements. We studied 324 ambulatory, anemic (hemoglobin <10 g/dl) HIV-infected adults. Study clinicians treated nearly all [315 (97.2%)] for suspected iron deficiency and/or helminthes; 56 (17.3%) had laboratory-confirmed malaria. Other assigned diagnoses included tuberculosis [30 (9.3%)], adverse drug reactions [26 (8.0%)], and bacteremia [13 (4.1%)]. Etiologic diagnosis was achieved in 79 (24.4%). Of 169 (52.2%) subjects who improved (hemoglobin increase of ≥1 g/dl without indications for hospitalization), only 65 (38.5%) received conventional management (iron supplementation, deworming, and/or antimalarials) alone. Thirty (9.3%) died and/or were hospitalized, and 125 (38.6%) were lost to follow-up. Multivariable linear and logistic regression models described better hemoglobin responses and/or outcomes in subjects with higher CD4(+) T-lymphocyte counts, pre-enrollment antiretroviral therapy and/or co-trimoxazole prophylaxis, discontinuation of zidovudine for suspected adverse reaction, and smear-positive tuberculosis. Adverse outcomes were associated with fever, low body mass index, bacteremia, esophageal candidiasis, and low or missing CD4(+) T cell counts. In this severely resource-limited setting, successful anemia management often required interventions other than conventional presumptive treatment, thus supporting Mozambique's guideline revision.
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Affiliation(s)
| | - Wilson P. Silva
- Friends in Global Health, LLC, Maputo, Mozambique, and Quelimane, Mozambique
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, Tennessee
| | - Sten H. Vermund
- Friends in Global Health, LLC, Maputo, Mozambique, and Quelimane, Mozambique
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
| | - Emilio Valverde
- Friends in Global Health, LLC, Maputo, Mozambique, and Quelimane, Mozambique
- Department of Health Policy, Vanderbilt University, Nashville, Tennessee
| | - Manuel Buene
- Friends in Global Health, LLC, Maputo, Mozambique, and Quelimane, Mozambique
| | - Troy D. Moon
- Friends in Global Health, LLC, Maputo, Mozambique, and Quelimane, Mozambique
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
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Abstract
HIV infection is related to an increased risk of cancer compared with general population, both AIDS-defining cancers (Kaposi's sarcoma, non Hodgkin's lymphoma, invasive cervical cancer) and non-AIDS-defining cancers. Although the advent of the highly active antiretroviral therapy era has decreased the Kaposi's sarcoma and non-Hodgkin's lymphoma incidences, non-AIDS-defining malignancies, such as lung cancer, hepatocarcinoma, anal cancer and skin cancers, remain a major cause of morbidity and death in the HIV-infected population. The clinical presentation is often different between the infected and non-infected populations, often with a more advanced stage at diagnosis, a more aggressive pathology, and associated morbidities like immunosuppression, leading to poorer outcomes. Numerous studies have focused on HIV-related malignancies' treatment, however specific guidelines are still missing. Practitioners have to be careful with interactions between antiretroviral and antineoplastic drugs, particularly through the cytochrome P 450. Because of this, a national multidisciplinary approach, "Cancer and HIV, " was started in 2013 thanks to the National Institute of Cancer (INCa). The aim of this review is to present a scientific update about AIDS-and non-AIDS-defining malignancies, both in their clinical aspects and regarding their specific therapeutic management.
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Shahani L, McKenna M. Primary pulmonary lymphoma in a patient with advanced AIDS. BMJ Case Rep 2014; 2014:bcr-2013-203265. [PMID: 25527680 DOI: 10.1136/bcr-2013-203265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Non-Hodgkin's lymphoma (NHL) is an AIDS defining lesion and risk of NHL most likely correlates with the degree of immunosuppression from HIV. Risk of NHL is highest among patients with CD4 count <50 cells/mL. Primary pulmonary lymphoma (PPL) is an infrequent cause of AIDS-related lymphoma. The authors report a patient with advanced AIDS presenting with recurrent fever and pulmonary nodule seen on the CT scan. The patient remained febrile despite being on broad spectrum antibiotics with no clear source of infection. The patient underwent a bronchoscopy with biopsy of the pulmonary lesion which was most consistent with diffuse large B-cell lymphoma. The patient was started on dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide and prednisone (EPOCH) and was noted to be afebrile and a repeat CT scan few weeks later showed resolution of her pulmonary nodule. This case highlights the importance of considering NHL in patients with advanced AIDS presenting with pulmonary nodule and fever.
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Affiliation(s)
- Lokesh Shahani
- Department of Infectious Disease, Baylor College of Medicine, Houston, Texas, USA
| | - Megan McKenna
- Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA
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Carbone A, Vaccher E, Gloghini A, Pantanowitz L, Abayomi A, de Paoli P, Franceschi S. Diagnosis and management of lymphomas and other cancers in HIV-infected patients. Nat Rev Clin Oncol 2014; 11:223-38. [PMID: 24614140 DOI: 10.1038/nrclinonc.2014.31] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Despite the introduction of highly active antiretroviral therapy or combination antiretroviral therapy (HAART and cART, respectively) patients infected with HIV might develop certain types of cancer more frequently than uninfected people. Lymphomas represent the most frequent malignancy among patients with HIV. Other cancer types that have increased in these patients include Kaposi sarcoma, cancer of the cervix, anus, lung and liver. In the post-HAART era, however, patients with HIV have experienced a significant improvement in their morbidity, mortality and life expectancy. This Review focuses on the different types of lymphomas that generally occur in patients with HIV. The combination of cART and antineoplastic treatment has resulted in remarkable prolongation of disease-free survival and overall survival among patients with HIV who develop lymphoma. However, the survival in these patients still lags behind that of patients with lymphoma who are not infected with HIV. We also provide an update of epidemiological data, diagnostic issues, and strategies regarding the most-appropriate management of patients with both HIV and lymphomas.
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Affiliation(s)
- Antonino Carbone
- Department of Pathology, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy
| | - Emanuela Vaccher
- Department of Medical Oncology, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy
| | - Annunziata Gloghini
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, USA
| | - Akin Abayomi
- Department of Pathology, Division of Haematology, Tygerberg Hospital, South Africa
| | - Paolo de Paoli
- Molecular Virology and Scientific Directorate, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy
| | - Silvia Franceschi
- Infections and Cancer Epidemiology Group, International Agency for Research on Cancer, France
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8
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Barta SK, Xue X, Wang D, Tamari R, Lee JY, Mounier N, Kaplan LD, Ribera JM, Spina M, Tirelli U, Weiss R, Galicier L, Boue F, Wilson WH, Wyen C, Oriol A, Navarro JT, Dunleavy K, Little RF, Ratner L, Garcia O, Morgades M, Remick SC, Noy A, Sparano JA. Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: a pooled analysis of 1546 patients. Blood 2013; 122:3251-62. [PMID: 24014242 PMCID: PMC3821722 DOI: 10.1182/blood-2013-04-498964] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 08/27/2013] [Indexed: 12/27/2022] Open
Abstract
Limited comparative data exist for the treatment of HIV-associated non-Hodgkin lymphoma. We analyzed pooled individual patient data for 1546 patients from 19 prospective clinical trials to assess treatment-specific factors (type of chemotherapy, rituximab, and concurrent combination antiretroviral [cART] use) and their influence on the outcomes complete response (CR), progression free survival (PFS), and overall survival (OS). In our analysis, rituximab was associated with a higher CR rate (odds ratio [OR] 2.89; P < .001), improved PFS (hazard ratio [HR] 0.50; P < .001), and OS (HR 0.51; P < .0001). Compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), initial therapy with more dose-intense regimens resulted in better CR rates (ACVBP [doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisolone]: OR 1.70; P < .04), PFS (ACVBP: HR 0.72; P = .049; "intensive regimens": HR 0.35; P < .001) and OS ("intensive regimens": HR 0.54; P < .001). Infusional etoposide, prednisone, infusional vincristine, infusional doxorubicin, and cyclophosphamide (EPOCH) was associated with significantly better OS in diffuse large B-cell lymphoma (HR 0.33; P = .03). Concurrent use of cART was associated with improved CR rates (OR 1.89; P = .005) and trended toward improved OS (HR 0.78; P = .07). These findings provide supporting evidence for current patterns of care where definitive evidence is unavailable.
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MESH Headings
- Anti-HIV Agents/therapeutic use
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active
- Clinical Trials as Topic
- Cyclophosphamide/therapeutic use
- Doxorubicin/therapeutic use
- Drug Administration Schedule
- Etoposide/therapeutic use
- HIV/drug effects
- HIV Infections/complications
- HIV Infections/drug therapy
- HIV Infections/mortality
- HIV Infections/virology
- Humans
- Infusions, Intravenous
- Lymphoma, AIDS-Related/complications
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/mortality
- Lymphoma, AIDS-Related/virology
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/mortality
- Lymphoma, Non-Hodgkin/virology
- Prednisone/therapeutic use
- Rituximab
- Survival Analysis
- Treatment Outcome
- Vincristine/therapeutic use
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Baxi S, Platts-Mills J, Dhruva S, Huang L, Hanks D, Dhaliwal G. A double-edged sword. J Hosp Med 2013; 8:47-51. [PMID: 23293015 DOI: 10.1002/jhm.1999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/01/2012] [Accepted: 11/07/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Sanjiv Baxi
- Department of Medicine, Division of Infectious Diseases, University of California San Francisco, San Francisco, California 94110, USA.
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10
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Tafuku S, Ishikawa C, Yasumoto T, Mori N. Anti-neoplastic effects of fucoxanthin and its deacetylated product, fucoxanthinol, on Burkitt's and Hodgkin's lymphoma cells. Oncol Rep 2012; 28:1512-8. [PMID: 22859062 DOI: 10.3892/or.2012.1947] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 07/06/2012] [Indexed: 01/27/2023] Open
Abstract
Fucoxanthin (FX) is a natural carotenoid with reported antitumorigenic activity. This study explored the effects of FX and its deacetylated product, fucoxanthinol (FXOH), on B-cell malignancies, including Burkitt's lymphoma, Hodgkin's lymphoma and Epstein-Barr virus-immortalized B cells. Both FX and FXOH reduced the viability of these malignant B cells in a dose-dependent manner accompanied by the induction of cell cycle arrest during G1 phase and caspase-dependent apoptosis. FXOH was approximately twice more potent than FX in these activities. In contrast, normal peripheral blood mononuclear cells were resistant to FX and FXOH. Strong and constitutive activation of nuclear factor-κB (NF-κB) is a common characteristic of many B-cell malignancies, and FXOH suppressed constitutive NF-κB activity. NF-κB inhibition was accompanied by downregulation of NF-κB-dependent anti-apoptotic and cell cycle regulator gene products, including Bcl-2, cIAP-2, XIAP, cyclin D1 and cyclin D2. The results indicated that FX and FXOH are potentially useful therapeutic agents in B-cell malignancies characterized by aberrant regulation of NF-κB.
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Affiliation(s)
- Senji Tafuku
- Department of Microbiology and Oncology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
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Bayraktar UD, Ramos JC, Petrich A, Gupta N, Lensing S, Moore PC, Reid EG, Aboulafia DM, Ratner L, Mitsuyasu R, Cooley T, Henry DH, Barr P, Noy A. Outcome of patients with relapsed/refractory acquired immune deficiency syndrome-related lymphoma diagnosed 1999-2008 and treated with curative intent in the AIDS Malignancy Consortium. Leuk Lymphoma 2012; 53:2383-9. [PMID: 22642936 DOI: 10.3109/10428194.2012.697559] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
No comparative studies exist for relapsed/refractory (rel/rfr) acquired immune deficiency syndrome (AIDS)-related lymphoma (ARL). To determine practices over the last decade and to assess the outcomes of salvage chemotherapy with curative intent and autologous stem cell transplant (ASCT), we retrospectively evaluated treatment outcomes in patients with rel/rfr ARL who were treated in 13 national AIDS Malignancy Consortium (AMC) sites between 1999 and 2008 (n = 88). The most commonly used second-line therapies were ICE (ifosfamide/carboplatin/etoposide, n = 34), dose adjusted EPOCH (etoposide/prednisone/vincristine/cyclophosphamide/doxorubicin, n = 17) and ESHAP (etoposide/methylprednisolone/cytarabine/cisplatin, n = 11). The odds of achieving a response were lower for those with non-Hodgkin lymphoma (NHL) than for those with HL and for those with primary refractory disease than for those with relapse. Overall survival (OS) was significantly longer for those with relapsed disease compared to those with refractory disease and for those with non-Burkitt NHL compared to those with Burkitt. OS was longer in patients who underwent ASCT compared to those who did not (1-year OS: 63.2% vs. 37.2%). However, among 32 patients (36%) who achieved a complete or partial response (CR/PR) after second-line therapy, 1-year OS was not different between the two groups (87.5% for ASCT vs. 81.8% for non-ASCT). Long-term survival in some patients with rel/rfr ARL may be possible without transplant, although transplant remains the standard of care for chemotherapy sensitive disease.
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Affiliation(s)
- Ulas D Bayraktar
- Division of Hematology/Oncology, University of Miami, Miami, FL, USA
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12
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Mwamba PM, Mwanda WO, Busakhala N, Strother RM, Loehrer PJ, Remick SC. AIDS-Related Non-Hodgkin's Lymphoma in Sub-Saharan Africa: Current Status and Realities of Therapeutic Approach. LYMPHOMA 2012; 2012:10.1155/2012/904367. [PMID: 24205439 PMCID: PMC3817848 DOI: 10.1155/2012/904367] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Today AIDS-related non-Hodgkin's lymphoma (AR-NHL) is a significant cause of morbidity and mortality in HIV-infected patients the world over, and especially in sub-Saharan Africa. While the overall incidence of AR-NHL since the emergence of combination antiretroviral therapy (cART) era has declined, the occurrence of this disease appears to have stabilized. In regions of the world where access to cART is challenging, the impact on disease incidence is less clear. In the resource-rich environment it is clinically well recognized that it is no longer appropriate to consider AR-NHL as a single disease entity and rather treatment of AIDS lymphoma needs to be tailored to lymphoma subtype. While intensive therapeutic strategies in the resource-rich world are clearly improving outcome, in AIDS epicenters of the world and especially in sub-Saharan Africa there is a paucity of data on treatment and outcomes. In fact, only one prospective study of dose-modified oral chemotherapy and limited retrospective studies with sufficient details provide a window into the natural history and clinical management of this disease. The scarcities and challenges of treatment in this setting provide a backdrop to review the current status and realities of the therapeutic approach to AR-NHL in sub-Saharan Africa. More pragmatic and risk-adapted therapeutic approaches are needed.
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Affiliation(s)
- Peter M. Mwamba
- Section Haematology and Blood Transfusion, Department of Human Pathology University of Nairobi College of Health Sciences Nairobi, Kenya
| | - Walter O. Mwanda
- Section Haematology and Blood Transfusion, Department of Human Pathology University of Nairobi College of Health Sciences Nairobi, Kenya
| | - NaftaliW. Busakhala
- Departments of Oncology and Pharmacology Moi University School of Medicine Eldoret, Kenya
| | | | - Patrick J. Loehrer
- Melvin and Bren Simon Cancer Center Indiana University, Indianapolis, IN, USA
| | - Scot C. Remick
- Mary Babb Randolph Cancer Center West Virginia University, Morgantown, WV, USA
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14
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Mori N, Ishikawa C, Senba M, Kimura M, Okano Y. Effects of AZD1152, a selective Aurora B kinase inhibitor, on Burkitt's and Hodgkin's lymphomas. Biochem Pharmacol 2011; 81:1106-15. [PMID: 21371446 DOI: 10.1016/j.bcp.2011.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 02/13/2011] [Accepted: 02/16/2011] [Indexed: 01/19/2023]
Abstract
We studied the effects of AZD1152, an Aurora B kinase inhibitor, on Burkitt's lymphoma (BL) and Hodgkin's lymphoma (HL) in human tissues and cell cultures and in a murine xenograft model of lymphoma. Aurora kinase A and B levels were assessed by RT-PCR and immunohistochemistry. They were aberrantly expressed in BL and HL cell lines, and in lymph nodes from patients with BL and HL. Next, activation of the Aurora B promoter was detected by reporter gene assays. The promoter activity of Aurora B kinase was high in BL cell lines and the Aurora B promoter contained a positive regulatory region between -74 and -104 from the transcription initiation site. AZD1152-hQPA had antiproliferative effects in the BL and HL cell lines studied; inhibited the phosphorylation of histone H3 and retinoblastoma proteins, and resulted in cells with > 4N DNA content. AZD1152-hQPA induced caspase-dependent apoptosis of some cell lines, demonstrated by loss of mitochondrial membrane potential, activation of caspase-9, followed by activation of caspase-3. This effect was accompanied by the inhibition of survivin expression. In vivo efficacy was determined in NOD/SCID/γc(null) mice implanted with the Ramos human BL cell line. AZD1152 had anti-tumour effects in this murine xenograft model. There preclinical data suggest that the inhibition of Aurora B kinase is a potentially useful therapeutic strategy in BL and HL.
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Affiliation(s)
- Naoki Mori
- Department of Microbiology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
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15
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Simard EP, Engels EA. Cancer as a cause of death among people with AIDS in the United States. Clin Infect Dis 2011; 51:957-62. [PMID: 20825305 DOI: 10.1086/656416] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND People with human immunodeficiency virus (HIV) infection and AIDS have an elevated risk for cancer. Highly active antiretroviral therapy (HAART), which has been widely available since 1996, has resulted in dramatic decreases in AIDS-related deaths. METHODS We evaluated cancer as a cause of death in a US registry-based cohort of 83,282 people with AIDS (1980-2006). Causes of death due to AIDS-defining cancers (ADCs) and non-ADCs (NADCs) were assessed. We evaluated mortality rates and the fraction of deaths due to cancer. Poisson regression assessed rates according to calendar year of AIDS onset. RESULTS Overall mortality decreased from 302 deaths per 1000 person-years in 1980-1989, to 140 deaths per 1000 person-years in 1990-1995, and to 29 deaths per 1000 person-years in 1996-2006. ADC-related mortality decreased from 2.95 deaths per 1000 person-years in 1980-1989 to 0.65 deaths per 1000 person-years in 1996-2006 (P < .01), but the fraction of ADC-related deaths increased from 1.05% to 2.47% in association with decreases in other AIDS-related deaths. Non-Hodgkin lymphoma was the most common cancer-related cause of death (36% of deaths during 1996-2006). Likewise, NADC-related mortality decreased from 2.21 to 0.84 deaths per 1000 person-years from the period 1980-1989 to the period 1996-2006 (P < .05), but the fraction of NADC-deaths increased to 3.16% during 1996-2006. Lung cancer was the most common NADC cause of death (21% of cancer-related deaths in 1996-2006). CONCLUSIONS Cancer-related mortality decreased in the HAART era, but because of decreasing mortality due to AIDS, cancers account for a growing fraction of deaths. Improved cancer prevention and treatment, particularly for non-Hodgkin lymphoma and lung cancer, would reduce mortality among people with AIDS.
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Affiliation(s)
- Edgar P Simard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland 20892, USA
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Ojha J, Gupta A, Aziz N. Intraoral diffuse large B-cell lymphoma with Burkitt-like morphology in an HIV-positive patient--a diagnostic dilemma. J Oral Maxillofac Surg 2010; 68:2632-8. [PMID: 20591554 DOI: 10.1016/j.joms.2009.09.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2009] [Revised: 09/07/2009] [Accepted: 09/11/2009] [Indexed: 11/30/2022]
Affiliation(s)
- Junu Ojha
- Department of Diagnostic Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI 48208-2576, USA.
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Bayraktar S, Bayraktar UD, Ramos JC, Stefanovic A, Lossos IS. Primary CNS lymphoma in HIV positive and negative patients: comparison of clinical characteristics, outcome and prognostic factors. J Neurooncol 2010; 101:257-65. [DOI: 10.1007/s11060-010-0252-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 05/20/2010] [Indexed: 10/19/2022]
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Santilli V, Mora N, Aquilani A, Tchidjou HK, Pontrelli G, De Vito R, Lombardi A, Bernardi S, Palma P. Burkitt's lymphoma mimicking EBV disease as first sign of vertical HIV infection in an adolescent. Ital J Pediatr 2010; 36:34. [PMID: 20416074 PMCID: PMC2873400 DOI: 10.1186/1824-7288-36-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 04/23/2010] [Indexed: 11/19/2022] Open
Abstract
Burkitt's Lymphoma (BL) rarely represents the first clinical manifestation of vertical HIV infection in adolescent in Western Europe. We report the case of a 17 year-old boy with two week history of fever and enlarged cervical lymph nodes firstly misdiagnosed as EBV infection, subsequently diagnosed as Burkitt's Lymphoma and vertical HIV infection.
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Affiliation(s)
- Veronica Santilli
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Nadia Mora
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Angela Aquilani
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Hyppolite K Tchidjou
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Giuseppe Pontrelli
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Rita De Vito
- Unit of Anatomical Pathology- Children's Hospital Bambino Gesù, Rome, Italy
| | | | - Stefania Bernardi
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Paolo Palma
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
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Tsukune Y, Isobe Y, Yasuda H, Shimizu S, Katsuoka Y, Hosone M, Oshimi K, Komatsu N, Sugimoto K. Activity and safety of combination chemotherapy with methotrexate, ifosfamide, l-asparaginase and dexamethasone (MILD) for refractory lymphoid malignancies: a pilot study. Eur J Haematol 2010; 84:310-5. [DOI: 10.1111/j.1600-0609.2009.01395.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bortolin MT, Zanussi S, Talamini R, Simonelli C, Pratesi C, Tedeschi R, Abbruzzese L, Manuele R, Rupolo M, Tirelli U, De Paoli P. Predictive value of HIV type 1 DNA levels on overall survival in HIV-related lymphoma Patients treated with high-dose chemotherapy (HDC) plus autologous stem cell transplantation (ASCT). AIDS Res Hum Retroviruses 2010; 26:245-51. [PMID: 20156109 DOI: 10.1089/aid.2009.0081] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The kinetics and predictive value of HIV-1 DNA (HIV DNA) levels in relapsed or refractory HIV lymphoma patients, treated with high-dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT), were investigated. HIV DNA was measured by real-time PCR in the peripheral blood mononuclear cells (PBMCs) of 22 patients observed for a median follow-up of 31.0 months. At baseline, HIV DNA was found to be correlated with HIV-1 RNA (HIV RNA) (r = 0.56), but not with CD4(+) counts (r = -0.10). HIV RNA load was under control for the entire follow-up, while HIV DNA levels were almost always detectable (baseline levels vs. 1 year from ASCT levels, p > 0.05). Baseline HIV DNA levels were significantly different between alive and deceased patients (p = 0.03), and the overall survival (OS) analysis showed that for patients with higher HIV DNA levels at baseline there was a higher and nearly significant risk of death if compared to patients with lower levels (HR, 8.33, 95% CI, 0.99-70.06, p = 0.05). Our study demonstrated that high HIV DNA levels at baseline could predict overall survival after ASCT in one of the largest cohorts of HIV lymphoma patients treated with salvage therapy.
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Affiliation(s)
- Maria Teresa Bortolin
- Microbiology, Immunology and Virology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Stefania Zanussi
- Microbiology, Immunology and Virology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Renato Talamini
- Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Cecilia Simonelli
- Division of Medical Oncology A, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Chiara Pratesi
- Microbiology, Immunology and Virology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Rosamaria Tedeschi
- Microbiology, Immunology and Virology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Luciano Abbruzzese
- Blood Bank and Department of Clinical Pathology and Immunohaematology, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Rosa Manuele
- Division of Medical Oncology A, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Maurizio Rupolo
- Division of Medical Oncology A, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Umberto Tirelli
- Division of Medical Oncology A, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Paolo De Paoli
- Microbiology, Immunology and Virology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
- Scientific Directorate, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
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Vaccher E, Tirelli U. Neoplastic disease. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00094-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Czepiel J, Kluba-Wojewoda U, Biesiada G, Mach T, Garlicki A. The case of a diffuse large B-cell lymphoma (DLBCL) in a course of HIV. HIV & AIDS REVIEW 2010. [DOI: 10.1016/s1730-1270(10)60095-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Mounier N, Katlama C, Costagliola D, Chichmanian RM, Spano JP. Drug interactions between antineoplastic and antiretroviral therapies: Implications and management for clinical practice. Crit Rev Oncol Hematol 2009; 72:10-20. [DOI: 10.1016/j.critrevonc.2008.10.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 10/07/2008] [Accepted: 10/17/2008] [Indexed: 11/25/2022] Open
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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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Vega MI, Martinez-Paniagua M, Jazirehi AR, Huerta-Yepez S, Umezawa K, Martinez-Maza O, Bonavida B. The NF-κB inhibitors (bortezomib and DHMEQ) sensitise rituximab-resistant AIDS-B-non-Hodgkin lymphoma to apoptosis by various chemotherapeutic drugs. Leuk Lymphoma 2009; 49:1982-94. [DOI: 10.1080/10428190802357071] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
We describe a newly diagnosed HIV-infected child, without prior history of AIDS-defining disease, who presented with Burkitt lymphoma-related cauda equina syndrome that rapidly progressed to a flaccid paraplegia. Diagnosis was confirmed on biopsy and magnetic resonance imaging of the spine showed multiple epidural masses with involvement of several vertebral bodies, cord edema and compression of the cord and cauda equina. The child's immune status was relatively preserved and Epstein-Barr serology proved negative. Chemotherapy (LMB 89 modified protocol) was initiated immediately after histopathologic confirmation, together with highly active antiretroviral therapy. A follow-up magnetic resonance imaging 6 weeks later showed segmental cord atrophy at the site of previous edema despite complete resolution of all the epidural masses. Unfortunately, the child's neurologic state did not improve beyond the recovery of sphincter control and lower limb sensation. The patient is the first reported case of Burkitt lymphoma-related spinal cord compression as an initial AIDS-defining illness, in a 10-year-old child. The outcome of the case highlights the importance of early diagnosis and prompt treatment of this aggressive tumor to avoid permanent neurologic deficits.
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Abstract
Besides traditional cytostatic drugs the introduction of monoclonal antibodies has substantially influenced current treatment concepts of non-Hodgkin's lymphoma (NHL). Rituximab, a monoclonal anti-CD20 chimeric antibody, now has been widely evaluated in the various B-cell lymphatic neoplasms. Large phase III studies helped to prove the value of this drug in follicular lymphoma as part of induction or relapse treatment as well as maintenance treatment. The addition of rituximab to the well established CHOP regimens has increased achievable cure rates in diffuse large cell lymphoma, and this combination is now accepted worldwide as standard of care. Although conflicting results are available, rituximab is widely used for the treatment of mantle cell lymphoma. For the less frequent lymphoma entities phase 2 studies show a considerable efficiency for most of these B-NHL variants. Current research focuses on combined chemoimmunotherapy approaches, optimization of dosing regimens, and combination with novel agents.
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Affiliation(s)
- Beate Hauptrock
- Hematology/Oncology, Johannes Gutenberg-University, Mainz, Germany
| | - Georg Hess
- Hematology/Oncology, Johannes Gutenberg-University, Mainz, Germany
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Tran H, Nourse J, Hall S, Green M, Griffiths L, Gandhi MK. Immunodeficiency-associated lymphomas. Blood Rev 2008; 22:261-81. [DOI: 10.1016/j.blre.2008.03.009] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Spano JP, Costagliola D, Katlama C, Mounier N, Oksenhendler E, Khayat D. AIDS-related malignancies: state of the art and therapeutic challenges. J Clin Oncol 2008; 26:4834-42. [PMID: 18591544 DOI: 10.1200/jco.2008.16.8252] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Despite the impact of combination antiretroviral therapy (cART) on HIV-related mortality, malignancy remains an important cause of death in the current era. Although the advent of cART has resulted in reductions in the incidence of Kaposi's sarcoma and non-Hodgkin's lymphoma, non-AIDS-defining malignancies present an increased risk for HIV-infected patients, characterized by some common clinical features, generally with a more aggressive behavior and a more advanced disease at diagnosis, which is responsible for poorer patient outcomes. Specific therapeutic recommendations are lacking for these new nonopportunistic malignancies, such as Hodgkin's lymphoma, anal cancer, lung cancer, hepatocarcinoma, and many others. Antiretroviral agents have a propensity for causing drug interactions as a result of their ability to either inhibit or induce the cytochrome P450 (CYP) enzyme system. Because many antineoplastic drugs are also metabolized by the CYP system, coadministration with cART could result in either drug accumulation with increased toxicity, or decreased efficacy of one or both classes of drugs. Further research delineating the combined safety and pharmacokinetics of antiretrovirals and antineoplastic therapy is necessary. Special considerations of these AIDS-related and non-AIDS-related malignancies and their clinical and therapeutic aspects constitute the subject of this review.
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Affiliation(s)
- Jean-Philippe Spano
- Pitié-Salpêtrière Hospital, Department of Medical Oncology, 47 Blvd de l'Hôpital, 75013 Paris, France.
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Makishi S, Okudaira T, Ishikawa C, Sawada S, Watanabe T, Hirashima M, Sunakawa H, Mori N. Retracted: A modified version of galectin-9 induces cell cycle arrest and apoptosis of Burkitt and Hodgkin lymphoma cells. Br J Haematol 2008; 142:583-94. [DOI: 10.1111/j.1365-2141.2008.07229.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Schmidt SM, Raible A, Kortüm F, Mayer F, Riessen R, Adam P, Gregor M, Bissinger AL. Successful treatment of multicentric Castleman's disease with combined immunochemotherapy in an AIDS patient with multiorgan failure. Leukemia 2008; 22:1782-5. [PMID: 18449205 DOI: 10.1038/leu.2008.54] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lee SC, Kim HJ, Bae SB, Kim CK, Lee NS, Lee KT, Park SK, Hong DS, Park HS, Jin SY, Won JH. Plasmablastic Lymphoma Mistaken for Perianal Abscess in Patient with AIDS. THE KOREAN JOURNAL OF HEMATOLOGY 2008. [DOI: 10.5045/kjh.2008.43.3.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sang-Cheol Lee
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Hyun-Jung Kim
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Sang-Byung Bae
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Chan-Kyu Kim
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Nam-Su Lee
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Kyu-Taek Lee
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Sung-Kyu Park
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Dae-Sik Hong
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Hee-Sook Park
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - So-Young Jin
- Department of Pathology, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Jong-Ho Won
- Division of Hematology & Oncology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
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Current Awareness in Hematological Oncology. Hematol Oncol 2007. [DOI: 10.1002/hon.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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