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AIDS-Related Malignancy
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Mark Bower, Elena Gervasi, Alessia Dalla Pria
People living with HIV have an increased risk of developing NHL, and the Centers for Disease Control (CDC) included high-grade B-cell non-Hodgkin lymphoma (NHL) as an AIDS-defining illness in 1985, and studies show a decline in incidence since the introduction of cART. The development of AIDS-related lymphoma (ARL) has been shown to be related to older age, low CD4 cell count, and absence of treatment with cART. Patients tend to present with advanced clinical stage, B symptoms, and extra-nodal sites of disease.
AIDS and other acquired immunodeficiencies
Published in Gabriel Virella, Medical Immunology, 2019
John W. Sleasman, Gabriel Virella
AIDS-related lymphoma is a consequence of combined long-term stimulation and proliferation of B cells caused by HIV itself in combination with reactivation of Epstein–Barr virus (EBV) infection as T-immunity wanes. Translocations involving chromosomes 8 and 14, as well as overexpression of EBV's LMP-1 are often detected in these lymphomas. The prognosis in patients with AIDS-related lymphoma is related to absolute CD4 T-cell counts, with the lowest counts (<100/μL) having the worst prognosis. Kaposi's sarcoma is caused by a virus of the herpes family (human herpes virus 8, HHV-8). Infections with this virus in HIV-positive patients seem to be associated with exaggerated release of IL-6, IL-1, TNF, and oncostatin M by activated macrophages, which would act synergistically in promoting the development of the vascular proliferative lesions typical of the tumor. The frequency of Kaposi's sarcoma has decreased after introduction of effective therapeutic modalities.
Cutaneous Neoplastic Manifestations of HIV Disease
Published in Clay J. Cockerell, Antoanella Calame, Cutaneous Manifestations of HIV Disease, 2012
Cindy Berthelot, Clay J. Cockerell
Lymphoma refers to a malignancy of lymphoid cells presenting in the lymph nodes, skin, viscera, or bone marrow. Although likely a manifestation of altered immunity, HIV itself may be a direct cause of AIDS-related lymphoma. HIV induces the expression of a variety of cytokines that are associated with the proliferation, stimulation, and activation of lymphocytes. Most cases of lymphoma in HIV-infected patients involve visceral sites, although it may first appear in the skin. If the lymphoma first appears on the skin, it is in the form of primary cutaneous lymphomas originating from cutaneous lymphocytes. Skin homing markers, such as the chemokine receptor CCR4 and cutaneous lymphocyte antigen, are displayed on cutaneous lymphocytes which guide them to the skin. This section will focus on cutaneous lymphomas associated with HIV infection.
A longitudinal and cross-sectional study ofEpstein-Barr virus DNA load: a possible predictor of AIDS-related lymphoma in HIV-infected patients
Published in Infectious Diseases, 2018
S. H. Hijlkema, J. J. A. van Kampen, J. J. C. Voermans, M. Y. E. den Oudsten, J. Doorduijn, P. J. van Lugtenburg, D. A. M. C. van de Vijver, M. E. van der Ende
Before the era of combined antiretroviral therapy (cART), HIV-infected patients were at more than hundred-fold greater risk of developing non-Hodgkin lymphoma and more than seven-fold greater risk of developing classical Hodgkin lymphoma compared to the general population [1]. Despite the declining incidence of AIDS-related lymphoma (ARL) since the introduction of cART [2,3], it constitutes >50% of all AIDS-related malignancies [4,5] and remains the main cause of AIDS-related deaths in HIV infected adults [5,6]. Epstein-Barr virus (EBV) is considered to be involved in the pathogenesis in around half of all ARL [7] and in nearly all cases of HIV-associated Hodgkin lymphoma [7–9]. Multiple studies reported on the value of EBV DNA load in plasma as a prognostic marker of ARL treatment [10–13]. The extent to which EBV-DNA is elevated in serum, plasma or blood before, at the time, and after ARL diagnosis is still insufficiently explored [12,13]. The main purpose of this study was to investigate whether a high peak EBV DNA load in HIV-infected patients is predictive of ARL, including classical Hodgkin lymphoma.
Isolated Abducens Palsy Heralding Occult Human Immunodeficiency Virus–Related Lymphoma
Published in Neuro-Ophthalmology, 2018
Brandon J. Baartman, Chrysavgi Adamopoulou
Systemic lymphoma underlying new-onset neurologic symptoms can be exceedingly difficult to detect. In evaluation of CSF for neoplastic cells, false-negative rate has been reported as high as 50%.8 Berger and colleagues reported three patients with isolated cranial neuropathy eventually diagnosed with acquired immunodeficiency syndrome (AIDS)-related systemic lymphoma, all of which had initially unremarkable CSF cytology, one even undergoing six total lumbar punctures, all repeatedly negative for lymphomatous cells.3 Each of the cases described in this report were eventually diagnosed by bone marrow biopsy, similar to the case presented here, likely owing to the frequent association between bone marrow and CNS infiltration by systemic lymphoma.4,9 The ability of MRI to detect lymphomatous involvement of the CNS has been discussed previously, with variable sensitivity in demonstrating leptomeningeal disease ranging from 23% to 71%.7 Cases of cranial neuropathy secondary to AIDS-related lymphoma have been reported to improve or resolve with institution of directed chemotherapy,2 and AIDS-related lymphomas have been recently reported to resolve with only institution of HAART.10
Celebrating Life Through City of Hope’s Bone Marrow Transplant Program
Published in Oncology Issues, 2020
In addition, City of Hope was one of the first hospitals to prove that BMTs can be done safely in patients with HIV. We performed the first transplant for AIDS‐related lymphoma in 1998. Today, BMT is also used to treat numerous nonmalignant diseases, including sickle cell disease and autoimmune diseases.