Skip to main content
SpringerLink
Log in

HIV-triggered lymphoma

  • short review
  • Published:
memo - Magazine of European Medical Oncology Aims and scope Submit manuscript

Summary

Treatment outcomes of AIDS-related lymphomas (acquired immune deficiency syndrome, ARL) have improved, nearing those reported for HIV-negative (human immunodeficiency virus) cohorts; recommended treatment protocols are herewith presented. The diagnostic approach to lymphoma in patients with HIV should include screening for and treatment of concomitant infections attributed to HIV-related immunosuppression. Appropriate antiretroviral treatment with adjustments for potential drug interactions should be initiated urgently, and recommended antibiotic, antifungal and antiviral prophylaxis commenced.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hernandez-Ramirez RU, Shiels MS, Dubrow R, Engels EA. Cancer risk in HIV-infected people in the USA from 1996 to 2012: a population-based, registry-linkage study. Lancet HIV. 2017;4(11):e495–e504.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Robbins HA, Shiels MS, Pfeiffer RM, Engels EA. Epidemiologic contributions to recent cancer trends among HIV-infected people in the United States. AIDS. 2014;28(6):881–90.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hunter NB, Vogt S, Ambinder RF. Treatment of HIV-associated lymphomas: the latest approaches for optimizing outcomes. Oncol (willist Park. 2017;31(12):872–7.

    Google Scholar 

  4. Dunleavy K, Wilson WH. How I treat HIV-associated lymphoma. Blood. 2012;119(14):3245–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Brunnberg U, Hentrich M, Hoffmann C, Wolf T, Hubel K. HIV-associated malignant Lymphoma. Oncol Res Treat. 2017;40(3):82–7.

    Article  CAS  PubMed  Google Scholar 

  6. Schommers P, Gillor D, Hentrich M, Wyen C, Wolf T, Oette M, et al. Incidence and risk factors for relapses in HIV-associated non-Hodgkin lymphoma as observed in the German HIV-related lymphoma cohort study. Haematologica. 2018;103(5):857–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Barta SK, Xue X, Wang D, Tamari R, Lee JY, Mounier N, et al. Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: a pooled analysis of 1546 patients. Blood. 2013;122(19):3251–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Mhlanga JC, Durand D, Tsai HL, Durand CM, Leal JP, Wang H, et al. Differentiation of HIV-associated lymphoma from HIV-associated reactive adenopathy using quantitative FDG PET and symmetry. Eur J Nucl Med Mol Imaging. 2014;41(4):596–604.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sathekge M. Differentiation of HIV-associated lymphoma from HIV-reactive adenopathy using quantitative FDG-PET and symmetry. Eur J Nucl Med Mol Imaging. 2014;41(4):593–5.

    Article  PubMed  Google Scholar 

  10. The Non-Hodgkin’s Lymphoma Classification Project. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma. Blood. 1997;89(11):3909–18.

    Google Scholar 

  11. Schommers P, Hentrich M, Hoffmann C, Gillor D, Zoufaly A, Jensen B, et al. Survival of AIDS-related diffuse large B‑cell lymphoma, Burkitt lymphoma, and plasmablastic lymphoma in the German HIV Lymphoma Cohort. Br J Haematol. 2015;168(6):806–10.

    Article  PubMed  Google Scholar 

  12. Kaplan LD, Lee JY, Ambinder RF, Sparano JA, Cesarman E, Chadburn A, et al. Rituximab does not improve clinical outcome in a randomized phase 3 trial of CHOP with or without rituximab in patients with HIV-associated non-Hodgkin lymphoma: AIDS-Malignancies Consortium Trial 010. Blood. 2005;106(5):1538–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Sparano JA, Lee JY, Kaplan LD, Levine AM, Ramos JC, Ambinder RF, et al. Rituximab plus concurrent infusional EPOCH chemotherapy is highly effective in HIV-associated B‑cell non-Hodgkin lymphoma. Blood. 2010;115(15):3008–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Wilson WH, Sin-Ho J, Pitcher BN, Hsi ED, Friedberg J, Cheson B, et al. Phase III randomized study of R‑CHOP versus DA-EPOCH‑R and molekular analysis of untreated diffuse large B‑cell Lymphoma: CALGB/alliance 50303. Blood. 2016;128(22):469.

    Google Scholar 

  15. Gibson TM, Morton LM, Shiels MS, Clarke CA, Engels EA. Risk of non-Hodgkin lymphoma subtypes in HIV-infected people during the HAART era: a population-based study. AIDS. 2014;28(15):2313–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Xicoy B, Ribera JM, Muller M, Garcia O, Hoffmann C, Oriol A, et al. Dose-intensive chemotherapy including rituximab is highly effective but toxic in human immunodeficiency virus-infected patients with Burkitt lymphoma/leukemia: parallel study of 81 patients. Leuk Lymphoma. 2014;55(10):2341–8.

    Article  CAS  PubMed  Google Scholar 

  17. Barnes JA, Lacasce AS, Feng Y, Toomey CE, Neuberg D, Michaelson JS, et al. Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt’s lymphoma: a retrospective analysis. Ann Oncol. 2011;22(8):1859–64.

    Article  CAS  PubMed  Google Scholar 

  18. Cortes J, Thomas D, Rios A, Koller C, O’Brien S, Jeha S, et al. Hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone and highly active antiretroviral therapy for patients with acquired immunodeficiency syndrome-related Burkitt lymphoma/leukemia. Cancer. 2002;94(5):1492–9.

    Article  CAS  PubMed  Google Scholar 

  19. Dunleavy K, Pittaluga S, Shovlin M, Steinberg SM, Cole D, Grant C, et al. Low-intensity therapy in adults with Burkitt’s lymphoma. N Engl J Med. 2013;369(20):1915–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Kaplan L. Human herpesvirus-8: Kaposi sarcoma, multicentric Castelman disease, and primary effusion lymphoma. Hematol Am Soc Hematol Educ Programm. 2013;2013:103–8.

    Article  Google Scholar 

  21. Brimo F, Michel RP, Khetani K, Auger M. Primary effusion lymphoma: a series of 4 cases and review of the literature with emphasis on cytomorphologic and immunocytochemical differential diagnosis. Cancer. 2007;111(4):224–33.

    Article  PubMed  Google Scholar 

  22. Galan J, Martin I, Carmona I, Rodriguez-Barbero JM, Cuadrado E, Garcia-Alonso L, et al. The utility of multiparametric flow cytometry in the detection of primary effusion lymphoma (PEL). Cytometry B Clin Cytom. 2018. https://doi.org/10.1002/cyto.b.21637.

    Article  PubMed  Google Scholar 

  23. Little RF, Pittaluga S, Grant N, Steinberg SM, Kavlick MF, Mitsuya H, et al. Highly effective treatment of acquired immunodeficiency syndrome-related lymphoma with dose-adjusted EPOCH: impact of antiretroviral therapy suspension and tumor biology. Blood. 2003;101(12):4653–9.

    Article  CAS  PubMed  Google Scholar 

  24. El-Ayass W, Yu EM, Karcher DS, Aragon-Ching JB. Complete response to EPOCH in a patient with HIV and extracavitary primary effusion lymphoma involving the colon: a case report and review of literature. Clin Lymphoma Myeloma Leuk. 2012;12(2):144–7.

    Article  PubMed  Google Scholar 

  25. Simonelli C, Spina M, Cinelli R, Talamini R, Tedeschi R, Gloghini A, et al. Clinical features and outcome of primary effusion lymphoma in HIV-infected patients: a single-institution study. J Clin Oncol. 2003;21(21):3948–54.

    Article  PubMed  Google Scholar 

  26. Terasaki Y, Okumura H, Saito K, Sato Y, Yoshino T, Ichinohasama R, et al. HHV-8/KSHV-negative and CD20-positive primary effusion lymphoma successfully treated by pleural drainage followed by chemotherapy containing rituximab. Intern Med. 2008;47(24):2175–8.

    Article  PubMed  Google Scholar 

  27. Foster WR, Bischin A, Dorer R, Aboulafia DM. Human Herpesvirus type 8‑associated large B‑cell Lymphoma: a nonserous extracavitary variant of primary effusion Lymphoma in an HIV-infected man: a case report and review of the literature. Clin Lymphoma Myeloma Leuk. 2016;16(6):311–21.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Waddington TW, Aboulafia DM. Failure to eradicate AIDS-associated primary effusion lymphoma with high-dose chemotherapy and autologous stem cell reinfusion: case report and literature review. Aids Patient Care Stds. 2004;18(2):67–73.

    Article  PubMed  Google Scholar 

  29. Won JH, Han SH, Bae SB, Kim CK, Lee NS, Lee KT, et al. Successful eradication of relapsed primary effusion lymphoma with high-dose chemotherapy and autologous stem cell transplantation in a patient seronegative for human immunodeficiency virus. Int J Hematol. 2006;83(4):328–30.

    Article  PubMed  Google Scholar 

  30. Bhatt S, Ashlock BM, Natkunam Y, Sujoy V, Chapman JR, Ramos JC, et al. CD30 targeting with brentuximab vedotin: a novel therapeutic approach to primary effusion lymphoma. Blood. 2013;122(7):1233–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Shah NN, Singavi AK, Harrington A. Daratumumab in primary effusion Lymphoma. N Engl J Med. 2018;379(7):689–90.

    Article  PubMed  Google Scholar 

  32. Siddiqi T, Joyce RM. A case of HIV-negative primary effusion lymphoma treated with bortezomib, pegylated liposomal doxorubicin, and rituximab. Clin Lymphoma Myeloma. 2008;8(5):300–4.

    Article  CAS  PubMed  Google Scholar 

  33. Hocqueloux L, Agbalika F, Oksenhendler E, Molina JM. Long-term remission of an AIDS-related primary effusion lymphoma with antiviral therapy. AIDS. 2001;15(2):280–2.

    Article  CAS  PubMed  Google Scholar 

  34. Halfdanarson TR, Markovic SN, Kalokhe U, Luppi M. A non-chemotherapy treatment of a primary effusion lymphoma: durable remission after intracavitary cidofovir in HIV negative PEL refractory to chemotherapy. Ann Oncol. 2006;17(12):1849–50.

    Article  CAS  PubMed  Google Scholar 

  35. Hentrich M, Berger M, Wyen C, Siehl J, Rockstroh JK, Muller M, et al. Stage-adapted treatment of HIV-associated Hodgkin lymphoma: results of a prospective multicenter study. J Clin Oncol. 2012;30(33):4117–23.

    Article  PubMed  Google Scholar 

  36. Eich HT, Diehl V, Gorgen H, Pabst T, Markova J, Debus J, et al. Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin’s lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol. 2010;28(27):4199–206.

    Article  PubMed  Google Scholar 

  37. Wang CC, Thanh C, Gibson EA, Ball-Burack M, Hogan LE, Descours B, et al. Transient loss of detectable HIV‑1 RNA following brentuximab vedotin anti-CD30 therapy for Hodgkin lymphoma. Blood Adv. 2018;2(23):3479–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Serrao A, Canichella M, De Luca ML, Tartaglia G, Annechini G, D’Elia GM, et al. Nivolumab as a safe and effective treatment in an HIV patient with refractory Hodgkin lymphoma. Ann Hematol. 2018. https://doi.org/10.1007/s00277-018-3541-0.

    Article  PubMed  Google Scholar 

  39. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Klein U, Gloghini A, Gaidano G, Chadburn A, Cesarman E, Dalla-Favera R, et al. Gene expression profile analysis of AIDS-related primary effusion lymphoma (PEL) suggests a plasmablastic derivation and identifies PEL-specific transcripts. Blood. 2003;101(10):4115–21.

    Article  CAS  PubMed  Google Scholar 

  41. Castillo JJ, Winer ES, Stachurski D, Perez K, Jabbour M, Milani C, et al. HIV-negative plasmablastic lymphoma: not in the mouth. Clin Lymphoma Myeloma Leuk. 2011;11(2):185–9.

    Article  PubMed  Google Scholar 

  42. Ibrahim IF, Shapiro GA, Naina HV. Treatment of HIV-associated plasmoblastic lymphoma: a single-center experience with 25 patients. J Clin Oncol. 2014;32:abstr 8583.

    Article  Google Scholar 

  43. Castillo JJ, Reagan JL, Sikov WM, Winer ES. Bortezomib in combination with infusional dose-adjusted EPOCH for the treatment of plasmablastic lymphoma. Br J Haematol. 2015;169(3):352–5.

    Article  CAS  PubMed  Google Scholar 

  44. Guerrero-Garcia TA, Mogollon RJ, Castillo JJ. Bortezomib in plasmablastic lymphoma: a glimpse of hope for a hard-to-treat disease. Leuk Res. 2017;62:12–6.

    Article  CAS  PubMed  Google Scholar 

  45. Balsalobre P, Diez-Martin JL, Re A, Michieli M, Ribera JM, Canals C, et al. Autologous stem-cell transplantation in patients with HIV-related lymphoma. J Clin Oncol. 2009;27(13):2192–8.

    Article  PubMed  Google Scholar 

  46. Diez-Martin JL, Balsalobre P, Re A, Michieli M, Ribera JM, Canals C, et al. Comparable survival between HIV+ and HIV- non-Hodgkin and Hodgkin lymphoma patients undergoing autologous peripheral blood stem cell transplantation. Blood. 2009;113(23):6011–4.

    Article  CAS  PubMed  Google Scholar 

  47. Tsutsumi Y, Yamamoto Y, Ito S, Ohigashi H, Shiratori S, Naruse H, et al. Hepatitis B virus reactivation with a rituximab-containing regimen. World J Hepatol. 2015;7(21):2344–51.

    Article  PubMed  PubMed Central  Google Scholar 

  48. NIH. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents 2019. 2018; http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf. Accessed: 20.07.2019.

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Haematology and Medical Oncology, LKH Feldkirch, Feldkirch, Austria

    Bernd Lorenz Hartmann & Michèle Desiré Atzl

Authors
  1. Bernd Lorenz Hartmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michèle Desiré Atzl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bernd Lorenz Hartmann.

Ethics declarations

Conflict of interest

B.L. Hartmann and M.D. Atzl declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hartmann, B.L., Atzl, M.D. HIV-triggered lymphoma. memo 12, 230–234 (2019). https://doi.org/10.1007/s12254-019-00518-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12254-019-00518-7

Keywords

Search

Navigation