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Clinical and pathological aspects of human immunodeficiency virus-associated plasmablastic lymphoma: analysis of 24 cases

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Abstract

Plasmablastic lymphoma (PBL) is a rare AIDS-related malignancy with a poor prognosis. Little is known about this entity, and no standard treatment regimen has been defined. To establish an adequate treatment strategy, we investigated 24 cases of PBL arising in human immunodeficiency virus-positive individuals. Most of the patients were in the AIDS stage, with a median CD4 count of 67.5/µL. Lymph nodes (58 %), gastrointestinal tract (42 %), bone marrow (39 %), oral cavity (38 %), and CNS (18 %) were the most commonly involved sites. Histology findings for the following were positive at varying rates, as follows: CD10 (56 %); CD30 (39 %); CD38 (87 %); MUM-1 (91 %); CD138 (79 %); EBER (91 %); and LMP-1 (18 %). There was a marked increase in patients in 2011–12, and the cases found in that period appeared to be more aggressive, showing a higher rate of advanced-stage PBL. Fourteen cases were treated with CHOP, while the others were treated with more intensive regimens, including bortezomib and hematopoietic stem cell transplantation. The overall median survival time was 15 months. A CD4 count of >100/µL at diagnosis and attaining complete remission in the first-line chemotherapy were associated with better outcomes (P = 0.027 and 0.0016, respectively). Host immune status and chemosensitivity are associated with improved prognosis in PBL.

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Acknowledgments

This work was partly supported by Health and Labor Sciences Research Grants [Nos. H22-AIDS-I-002 and H25-AIDS-I-002] from the Ministry of Health, Labor and Welfare.

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Authors and Affiliations

  1. Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan

    Yusuke Koizumi & Hiroshige Mikamo

  2. Department of Hematology, Shiga University of Medical Science, Otsu, Shiga, Japan

    Yusuke Koizumi, Hitoshi Minamiguchi & Keiko Hodohara

  3. Department of Infectious Diseases, Osaka National Hospital, Osaka, Osaka, Japan

    Yusuke Koizumi, Tomoko Uehira, Yoshihiko Ogawa, Keishiro Yajima, Dai Watanabe & Takuma Shirasaka

  4. Department of Pathology, Institute of Medical Science, University of Tokyo, Tokyo, Japan

    Yasunori Ota

  5. AIDS Clinical Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan

    Junko Tanuma

  6. Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan

    Mihoko Yotsumoto

  7. Department of Hematology, National Center for Global Health and Medicine Hospital, Tokyo, Japan

    Shotaro Hagiwara

  8. Department of Hematology and Oncology, University of Fukui Hospital, Fukui, Fukui, Japan

    Satoshi Ikegaya

  9. Division of Biostatistics, Clinical Research Center, Aichi Medical University, Nagakute, Aichi, Japan

    Kenta Murotani

  10. Department of Hematology, Kawasaki Medical School, Kawasaki, Okayama, Japan

    Hideho Wada

  11. Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Atsushi Ajisawa

  12. Department of Hematology, Nagoya Medical Center, Nagoya, Aichi, Japan

    Hirokazu Nagai

  13. Department of Pathology, Osaka National Hospital, Osaka, Osaka, Japan

    Yoshinori Kodama

  14. Department of Pathology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Tsunekazu Hishima

  15. Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan

    Makoto Mochizuki

  16. Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan

    Harutaka Katano

  17. Center for AIDS Research, Kumamoto University, Kumamoto, Kumamoto, Japan

    Seiji Okada

Authors
  1. Yusuke Koizumi
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  2. Tomoko Uehira
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  3. Yasunori Ota
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  4. Yoshihiko Ogawa
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  5. Keishiro Yajima
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  6. Junko Tanuma
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  7. Mihoko Yotsumoto
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  8. Shotaro Hagiwara
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  9. Satoshi Ikegaya
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  10. Dai Watanabe
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  11. Hitoshi Minamiguchi
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  12. Keiko Hodohara
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  13. Kenta Murotani
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  14. Hiroshige Mikamo
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  15. Hideho Wada
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  16. Atsushi Ajisawa
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  17. Takuma Shirasaka
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  18. Hirokazu Nagai
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  19. Yoshinori Kodama
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  20. Tsunekazu Hishima
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  21. Makoto Mochizuki
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  22. Harutaka Katano
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  23. Seiji Okada
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Corresponding author

Correspondence to Yusuke Koizumi.

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The authors declare that they have no conflict of interest. A summary of relevant information will be published with the manuscript.

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Koizumi, Y., Uehira, T., Ota, Y. et al. Clinical and pathological aspects of human immunodeficiency virus-associated plasmablastic lymphoma: analysis of 24 cases. Int J Hematol 104, 669–681 (2016). https://doi.org/10.1007/s12185-016-2082-3

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  • DOI: https://doi.org/10.1007/s12185-016-2082-3

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