Improved Survival in HIV-Associated Diffuse Large B-Cell Lymphoma with the Addition of Rituximab to Chemotherapy in Patients Receiving Highly Active Antiretroviral Therapy

2007 ◽  
Vol 8 (3) ◽  
pp. 132-144 ◽  
Author(s):  
H. Ezzat ◽  
D. Filipenko ◽  
L. Vickars ◽  
P. Galbraith ◽  
C. Li ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
B Cell ◽  
Highly Active Antiretroviral Therapy ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Highly Active ◽  
Large B Cell Lymphoma ◽  
Large B Cell

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

2017 ◽  
Vol 28 (9) ◽  
pp. 932-936 ◽  
Author(s):  
Do Hyoung Lim ◽  
Ji-Young Rhee ◽  
Keon Woo Park
Keyword(s):  
Antiretroviral Therapy ◽  
B Cell ◽  
Highly Active Antiretroviral Therapy ◽  
Cell Lymphoma ◽  
Stage Iv ◽  
B Cell Lymphoma ◽  
High Grade ◽  
Highly Active ◽  
Large B Cell Lymphoma ◽  
Large B Cell

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.

scholarly journals How I treat HIV-associated lymphoma

Blood ◽  
2012 ◽  
Vol 119 (14) ◽  
pp. 3245-3255 ◽  
Author(s):  
Kieron Dunleavy ◽  
Wyndham H. Wilson
Keyword(s):  
Antiretroviral Therapy ◽  
B Cell ◽  
Cell Lymphoma ◽  
Tumor Biology ◽  
B Cell Lymphoma ◽  
Combination Antiretroviral Therapy ◽  
Large B Cell Lymphoma ◽  
New Treatment ◽  
Novel Therapeutic Strategies ◽  
Large B Cell

Abstract Over the past 10 years, significant progress has been made in understanding HIV-associated lymphomas and improving the prognosis of these diseases. With the advent of combination antiretroviral therapy and the development of novel therapeutic strategies, most patients with HIV-associated lymphomas are cured. The outcome for the majority of patients with HIV-associated diffuse large B-cell lymphoma and Burkitt lymphoma in particular, is excellent, with recent studies supporting the role of rituximab in these diseases. Indeed, in the combination antiretroviral therapy era, the curability of many patients with HIV-associated lymphoma is similar to their HIV-negative counterparts. New treatment frontiers need to focus on improving the outcome for patients with advanced immune suppression and for those with adverse tumor biology, such as the activated B-cell type of diffuse large B-cell lymphoma and the virally driven lymphomas. Future clinical trials need to investigate novel targeted agents alone and in combination with chemotherapy.

BCL-2 Expression May Adversely Affect Outcome in HIV-Associated Systemic Diffuse Large B Cell Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4674-4674 ◽  
Author(s):  
Hatoon Ezzat ◽  
J. Doug Filipenko ◽  
Linda M. Vickars ◽  
Paul F. Galbraith ◽  
Charles H. Li ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Biopsy Material ◽  
Highly Active ◽  
Large B Cell Lymphoma ◽  
Multi Agent ◽  
Ecog Ps ◽  
Large B Cell

Abstract BCL-2 expression in diffuse large B cell lymphoma (DLBCL) in HIV-negative patients (pts) is associated with inferior outcome, an effect at least partially overcome by the addition of rituximab (R) to multi-agent chemotherapy (MA-CT). The effect of BCL-2 expression on DLBCL outcome in HIV-positive pts is less well defined. We performed a retrospective clinical-pathological correlation in 141 pts with systemic HIV-associated lymphoma seen at St. Paul’s Hospital between 1982 and 2004; this analysis includes 36 DLBCL since 1992. Clinical DLBCL data were obtained by chart review; HIV-associated data from the data-base of the BC Centre For Excellence in HIV/AIDS. Stored biopsy material diagnostic of DLBCL was sectioned and stained for BCL-2 expression. Median age at DLBCL diagnosis (dx) was 42 (range 20–64)y, DLBCL stage advanced 27; ECOG PS >1 n=11; median LDH ratio 1.4 (0.5–8.6); IPI >2 n=11; CD4 at DLBCL dx >100 n=21; prior AIDS dx n=18; hepatitis B and/or C n=9; on highly active anti-retroviral therapy (HAART) at DLBCL dx n=11; BCL-2+ n=11. HAART with DLBCL treatment (tx) n=17; received CHOP-R n=9, CHOP or ACOP n=18; G-CSF n=10; herpes virus tx n=10; PCP prophylaxis n=35. Significant factors for inferior overall survival (OS) included prior AIDS, median OS (MS) 3.2 vs. 7.4 mo with no AIDS; no HAART use, MS 2.6 vs. 5.2 mo with HAART; BCL-2+, MS 3.2 vs. 5.2 mo for BCL-2 negative; and receiving MA-CT without R, MS 3.8 vs. 7.6 mo for MA-CT + R (p<0.05 for all factors). Though a statistically significant effect could not be confirmed, the use of MA-CT + R appeared to improve progression-free survival (PFS) in BCL-2+ DLBCL, PFS 3 of 3 pts at 2.3 mo (2 on HAART) vs. 2 of 6 (33%, 2 on HAART) PFS at 2.1 mo for MA-CT without R. PFS for 6 pts receiving HAART and MA-CT + R (3 BCL-2+) was 100% at 2.3 mo, while for 12 pts receiving HAART and MA-CT without R (2 BCL-2+), median PFS was 2.0 (range 1–10.1) mo or 55% PFS at 2.1 mo. For pts not receiving HAART; MA-CT (n=4, 2 BCL-2+), 3 progressed at 0.5, 5.3 and 8.8 mo and died of DLBCL, and one died of treatment-related toxicity at 2.6 mo; MA-CT + R, 2 of 2 pts (neither BCL-2+) progressed at 3 and 11 mo. There were 15 documented episodes of treatment-related toxicity in 13 of 24 pts (54%) in the MA-CT group and 24 episodes in 7 of 9 pts (79%) in the MA-CT + R group (p<0.76). There were 13 (54%) toxic deaths with MA-CT vs. 2 (22%) with MA-CT + R (neither pt receiving HAART; p<0.07) as opposed to 2 (22%) and 13 (54%), respectively, deaths from DLBCL (p<0.02). Overall mortality was MA-CT n=19 (79%); MA-CT + R n=4 (44%), p<0.07. In conclusion, in this single-centre series of 36 pts with HIV-associated systemic DLBCL, of pts receiving no HAART, outcome was inferior in BCL-2+ DLBCL, an effect not seen with HAART. BCL-2+ DLBCL had inferior outcome in pts receiving MA-CT, an effect not seen with MA-CT + R. These data suggest that in BCL-2+ DLBCL in HIV, HAART and rituximab with chemotherapy are important in overcoming a BCL-2 effect.

HIV-infection impact on clinical–biological features and outcome of diffuse large B-cell lymphoma treated with R-CHOP in the combination antiretroviral therapy era

AIDS ◽  
2015 ◽  
Vol 29 (7) ◽  
pp. 811-818 ◽  
Author(s):  
Maria Joao Baptista ◽  
Olga Garcia ◽  
Mireia Morgades ◽  
Eva Gonzalez-Barca ◽  
Pilar Miralles ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Combination Antiretroviral Therapy ◽  
Biological Features ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Outcomes for HIV-associated diffuse large B-cell lymphoma in the modern combined antiretroviral therapy era

AIDS ◽  
2017 ◽  
Vol 31 (18) ◽  
pp. 2493-2501 ◽  
Author(s):  
Caroline Besson ◽  
Remi Lancar ◽  
Sophie Prevot ◽  
Michele Algarte-Genin ◽  
Pierre Delobel ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Combined Antiretroviral Therapy ◽  
Large B Cell
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