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A case of HIV-associated lymphoproliferative disease that was successfully treated with highly active antiretroviral therapy

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Abstract

We report a case of a 41-year-old male with human immunodeficiency virus (HIV)-associated lymphoproliferative disease (LPD) who was successfully treated with highly active antiretroviral therapy (HAART). He presented with epigastralgia, and an upper endoscopic examination revealed submucosal tumors and ulcerations in his stomach. Histopathologic examination of a biopsy specimen resulted in a diagnosis of diffuse large B-cell lymphoma. He also showed systemic lymphadenopathy; whereas, a concurrent inguinal lymph node biopsy produced a diagnosis of follicular hyperplasia. He was treated with CHOP chemotherapy but the response was poor. He demonstrated several immunological abnormalities, such as eosinophilia and bone marrow insufficiency, and was suspected to be in an immunocompromised state. He was examined for HIV infection and turned out to be positive. The gastric and inguinal lymph node specimens were re-evaluated and diagnoses of HIV-LPD and HIV lymphadenitis were made, respectively. He was treated with HAART and achieved complete remission and has remained tumor-free for 20 months. To the best of our knowledge, there is no previous report in which HIV-LPD was successfully treated with antiretroviral therapy alone. It is assumed that HAART resulted in the restoration of anti-tumor immunity in this case, which led to the eradication of LPD cells.

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References

  1. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC press; 2008. p. 340–342.

  2. Rezk SA, Weiss LM. Epstein-Barr virus-associated lymphoproliferative disorders. Hum Pathol. 2007;38:1293–304.

    Article  CAS  PubMed  Google Scholar 

  3. Pinkerton CR, Hann I, Weston CL, Mapp T, Wotherspoon A, Hobson R, et al. Immunodeficiency-related lymphoproliferative disorders: prospective data from the United Kingdom Children’s Cancer Study Group Registry. Br J Haematol. 2002;118:456–61.

    Article  CAS  PubMed  Google Scholar 

  4. van Dongen JJ, Langerak AW, Bruggemann M, Evans PA, Hummel M, Lavender FL, et al. Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia. 2003;17:2257–317.

    Article  PubMed  Google Scholar 

  5. Wenig BM, Thompson LD, Frankel SS, Burke AP, Abbondanzo SL, Sesterhenn I, et al. Lymphoid changes of the nasopharyngeal and palatine tonsils that are indicative of human immunodeficiency virus infection. A clinicopathologic study of 12 cases. Am J Surg Pathol. 1996;20:572–87.

    Article  CAS  PubMed  Google Scholar 

  6. Harris NL, Ferry JA, Swerdlow SH. Posttransplant lymphoproliferative disorders: summary of Society for Hematopathology Workshop. Semin Diagn Pathol. 1997;14:8–14.

    CAS  PubMed  Google Scholar 

  7. Tao J, Valderrama E. Epstein–Barr virus-associated polymorphic B-cell lymphoproliferative disorders in the lungs of children with AIDS: a report of two cases. Am J Surg Pathol. 1999;23:560–6.

    Article  CAS  PubMed  Google Scholar 

  8. Martin A, Flaman JM, Frebourg T, Davi F, El Mansouri S, Amouroux J, et al. Functional analysis of the p53 protein in AIDS-related non-Hodgkin’s lymphomas and polymorphic lymphoproliferations. Br J Haematol. 1998;101:311–7.

    Article  CAS  PubMed  Google Scholar 

  9. Oyama T, Yamamoto K, Asano N, Oshiro A, Suzuki R, Kagami Y, et al. Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group: a study of 96 patients. Clin Cancer Res. 2007;13:5124–32.

    Article  CAS  PubMed  Google Scholar 

  10. Pantaleo G, Graziosi C, Fauci AS. New concepts in the immunopathogenesis of human immunodeficiency virus infection. N Engl J Med. 1993;328:327–35.

    Article  CAS  PubMed  Google Scholar 

  11. Ioachim HL, Cronin W, Roy M, Maya M. Persistent lymphadenopathies in people at high risk for HIV infection. Clinicopathologic correlations and long-term follow-up in 79 cases. Am J Clin Pathol. 1990;93:208–18.

    CAS  PubMed  Google Scholar 

  12. Nador RG, Chadburn A, Gundappa G, Cesarman E, Said JW, Knowles DM. Human immunodeficiency virus (HIV)-associated polymorphic lymphoproliferative disorders. Am J Surg Pathol. 2003;27:293–302.

    Article  PubMed  Google Scholar 

  13. Wang X, Nathan S, Catchatourian R, Richter H 3rd, Kovarik P. Polymorphic lymphoid proliferation presenting as ileocecal intussusception. Ann Hematol. 2007;86:453–4.

    Article  CAS  PubMed  Google Scholar 

  14. Spina M, Jaeger U, Sparano JA, Talamini R, Simonelli C, Michieli M, et al. Rituximab plus infusional cyclophosphamide, doxorubicin, and etoposide in HIV-associated non-Hodgkin lymphoma: pooled results from 3 phase 2 trials. Blood. 2005;105:1891–7.

    Article  CAS  PubMed  Google Scholar 

  15. Boue F, Gabarre J, Gisselbrecht C, Reynes J, Cheret A, Bonnet F, et al. Phase II trial of CHOP plus rituximab in patients with HIV-associated non-Hodgkin’s lymphoma. J Clin Oncol. 2006;24:4123–8.

    Article  CAS  PubMed  Google Scholar 

  16. 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;106:1538–43.

    Article  CAS  PubMed  Google Scholar 

  17. Hui CK, Cheung WW, Zhang HY, Au WY, Yueng YH, Leung AY, et al. Kinetics and risk of de novo hepatitis B infection in HBsAg-negative patients undergoing cytotoxic chemotherapy. Gastroenterology. 2006;131:59–68.

    Article  CAS  PubMed  Google Scholar 

  18. Hoffmann C, Wolf E, Fatkenheuer G, Buhk T, Stoehr A, Plettenberg A, et al. Response to highly active antiretroviral therapy strongly predicts outcome in patients with AIDS-related lymphoma. Aids. 2003;17:1521–9.

    Article  PubMed  Google Scholar 

  19. Matthews GV, Bower M, Mandalia S, Powles T, Nelson MR, Gazzard BG. Changes in acquired immunodeficiency syndrome-related lymphoma since the introduction of highly active antiretroviral therapy. Blood. 2000;96:2730–4.

    CAS  PubMed  Google Scholar 

  20. Ribera JM, Oriol A, Morgades M, Gonzalez-Barca E, Miralles P, Lopez-Guillermo A, et al. Safety and efficacy of cyclophosphamide, adriamycin, vincristine, prednisone and rituximab in patients with human immunodeficiency virus-associated diffuse large B-cell lymphoma: results of a phase II trial. Br J Haematol. 2008;140:411–9.

    Article  CAS  PubMed  Google Scholar 

  21. Monini P, Sgadari C, Toschi E, Barillari G, Ensoli B. Antitumour effects of antiretroviral therapy. Nat Rev Cancer. 2004;4:861–75.

    Article  CAS  PubMed  Google Scholar 

  22. Bower M, McCall-Peat N, Ryan N, Davies L, Young AM, Gupta S, et al. Protease inhibitors potentiate chemotherapy-induced neutropenia. Blood. 2004;104:2943–6.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Haruyuki Fujita, Momoko Nishikori, Akifumi Takaori-Kondo, Noriyoshi Yoshinaga, Yoshiaki Ohara, Takayuki Ishikawa & Takashi Uchiyama

  2. Department of Pathology, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Hironori Haga

  3. Department of Pathology, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan

    Hironori Haga

  4. Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan

    Takashi Uchiyama

Authors
  1. Haruyuki Fujita
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  2. Momoko Nishikori
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  3. Akifumi Takaori-Kondo
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  4. Noriyoshi Yoshinaga
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  5. Yoshiaki Ohara
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  6. Takayuki Ishikawa
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  7. Hironori Haga
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  8. Takashi Uchiyama
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Correspondence to Momoko Nishikori.

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Fujita, H., Nishikori, M., Takaori-Kondo, A. et al. A case of HIV-associated lymphoproliferative disease that was successfully treated with highly active antiretroviral therapy. Int J Hematol 91, 692–698 (2010). https://doi.org/10.1007/s12185-010-0542-8

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  • DOI: https://doi.org/10.1007/s12185-010-0542-8

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