scholarly journals Hodgkin Lymphoma in People Living with HIV

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4366
Author(s):  
Jose-Tomas Navarro ◽  
José Moltó ◽  
Gustavo Tapia ◽  
Josep-Maria Ribera
Keyword(s):  
Hodgkin Lymphoma ◽  
Interdisciplinary Collaboration ◽  
Survival Rates ◽  
People Living With Hiv ◽  
Barr Virus ◽  
Non Hodgkin Lymphoma ◽  
Combined Antiretroviral Therapy ◽  
Epstein Barr ◽  
Living With Hiv ◽  
Hiv Negative

Despite widespread use of combined antiretroviral therapy (cART) and increased life expectancy in people living with HIV (PLWH), HIV-related lymphomas (HRL) remain a leading cause of cancer morbidity and mortality for PLWH, even in patients optimally treated with cART. While the incidence of aggressive forms of non-Hodgkin lymphoma decreased after the advent of cART, incidence of Hodgkin lymphoma (HL) has increased among PLWH in recent decades. The coinfection of Epstein–Barr virus plays a crucial role in the pathogenesis of HL in the HIV setting. Currently, PLWH with HRL, including HL, are treated similarly to HIV-negative patients and, importantly, the prognosis of HL in PLWH is approaching that of the general population. In this regard, effective cART during chemotherapy is strongly recommended since it has been shown to improve survival rates in all lymphoma subtypes, including HL. As a consequence, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential drug–drug interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PLWH with HL. In this article the authors review and update the epidemiological, clinical and biological aspects of HL presenting in PLWH with special emphasis on advances in prognosis and the factors that have contributed to it.

scholarly journals Hodgkin Lymphoma in People Living With HIV

2021 ◽  
Author(s):  
Jose Tomas Navarro ◽  
Jose Moltó ◽  
Gustavo Tapia ◽  
Josep Maria Ribera
Keyword(s):  
Hodgkin Lymphoma ◽  
Interdisciplinary Collaboration ◽  
Survival Rates ◽  
People Living With Hiv ◽  
Barr Virus ◽  
Non Hodgkin Lymphoma ◽  
Combined Antiretroviral Therapy ◽  
Epstein Barr ◽  
Living With Hiv ◽  
Hiv Negative

Despite widespread use of combined antiretroviral therapy (cART) and increased life expectancy in people living with HIV (PLWH), HIV-related lymphomas (HRL) remain a leading cause of cancer morbidity and mortality for PLWH, even in patients optimally treated with cART. While incidence of aggressive forms of non-Hodgkin lymphoma decreased after cART advent, incidence of Hodgkin lymphoma (HL) has increased among PLWH in recent decades. The coinfection of Epstein Barr virus plays a crucial role in the pathogenesis of HL in the HIV setting. Currently, PLWH with HRL, including HL, are treated similarly to HIV-negative patients and, importantly, the prognosis of HL in PLWH is approaching to that of the general population. In this regard, effective chem-otherapy is strongly recommended since it has been shown to improve survival rates in all lymphoma subtypes, including HL. As a consequence, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential drug-drug interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the op-timal treatment of PLWH with HL. In this article the authors review and update the epidemio-logical, clinical and biological aspects of HL presenting in PLWH with special emphasis in the improvement on prognosis and the factors that have contributed to it.

scholarly journals Impact of tumor Epstein-Barr virus status on presenting features and outcome in age-defined subgroups of patients with classic Hodgkin lymphoma: a population-based study

Blood ◽  
2005 ◽  
Vol 106 (7) ◽  
pp. 2444-2451 ◽  
Author(s):  
Ruth F. Jarrett ◽  
Gail L. Stark ◽  
Jo White ◽  
Brian Angus ◽  
Freda E. Alexander ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Older Patients ◽  
Epstein Barr Virus ◽  
Statistical Significance ◽  
Survival Rates ◽  
Population Based ◽  
Population Based Study ◽  
Barr Virus ◽  
Epstein Barr ◽  
The Impact

AbstractThe association between tumor Epstein-Barr virus (EBV) status and clinical outcome in Hodgkin lymphoma (HL) is controversial. This population-based study assessed the impact of EBV status on survival in age-stratified cohorts of adults with classic HL (cHL). Data from 437 cases were analyzed with a median follow-up of 93 months. Overall survival (OS) was significantly better for EBV-negative compared with EBV-positive patients (P < .001), with 5-year survival rates of 81% and 66%, respectively; disease-specific survival (DSS) was also greater for EBV-negative patients (P = .03). The impact of EBV status varied with age at diagnosis. In patients aged 16 to 34 years, EBV-associated cases had a survival advantage compared with EBV-negative cases, but differences were not statistically significant (P = .21). Among patients 50 years or older, EBV positivity was associated with a significantly poorer outcome (P = .003). Excess deaths occurred in EBV-positive patients with both early- and advanced-stage disease. In multivariate analysis of OS in the older patients, EBV status retained statistical significance after adjusting for the effects of sex, stage, and B symptoms (P = .01). Impaired immune status may contribute to the development of EBV-positive cHL in older patients, and strategies aimed at boosting the immune response should be investigated in the treatment of these patients. (Blood. 2005;106:2444-2451)

scholarly journals Subtypes of Epstein-Barr virus in human immunodeficiency virus- associated non-Hodgkin lymphoma

Blood ◽  
1991 ◽  
Vol 78 (11) ◽  
pp. 3004-3011 ◽  
Author(s):  
MJ Boyle ◽  
WA Sewell ◽  
TB Sculley ◽  
A Apolloni ◽  
JJ Turner ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hodgkin Lymphoma ◽  
Epstein Barr Virus ◽  
Type I ◽  
Type B ◽  
Barr Virus ◽  
Non Hodgkin Lymphoma ◽  
Immunodeficiency Virus ◽  
High Prevalence ◽  
Epstein Barr

Abstract Biopsy samples obtained from 20 patients with human immunodeficiency virus (HIV)-associated non-Hodgkin lymphoma (NHL) were assessed for evidence of Epstein-Barr virus (EBV) and HIV sequences. DNA was extracted from formalin-fixed, paraffin-embedded NHL tissue and specific viral gene sequences were sought using the polymerase chain reaction (PCR). EBV sequences were found in 10 NHL samples (50%), with five tumors showing A-type and five B-type sequences. By serologic testing, 18 of 19 patients had antibodies to EBV, with 14 patients having antibodies to A-type EBV and 11 to B-type EBV. Serology confirmed the high prevalence of type B EBV in HIV-infected patients, but was not a reliable indicator of the EBV subtype present in the lymphomas. HIV sequences were present in biopsy tissue but at a level consistent with an origin from bystander HIV-infected cells. All 20 patients were negative by enzyme-linked immunosorbent assay for antibodies to human T-cell leukemia virus-type I. The high prevalence of type B EBV in these tumors is similar to the findings in endemic Burkitt's lymphoma, where 40% of the tumors have type B viral sequences. In normal populations, type B EBV is rarely found outside the nasopharynx. These studies support the hypothesis that EBV is an important cofactor in NHL in HIV-infected persons. The finding that B- type EBV is present in 25% of HIV-associated NHL suggests that this EBV subtype may be an important human pathogen with a wider geographic distribution than originally thought.

scholarly journals Detección del Virus de Epstein-Barr en linfoma mediante qPCR //Detection of Epstein-Barr Virus (EBV) in lymphoma through qPCR

Ciencia Unemi ◽  
2018 ◽  
Vol 11 (26) ◽  
pp. 126 ◽  
Author(s):  
Sunny Sánchez-Giler ◽  
Alan Herrera-Vásquez ◽  
Claudia Castillo-Zambrano ◽  
Luis Solórzano-Alava ◽  
Dolores Zambrano-Castro ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Malignant Tumors ◽  
Tissue Samples ◽  
Virus Identification ◽  
Barr Virus ◽  
Non Hodgkin Lymphoma ◽  
Latently Infected ◽  
Infected Cells ◽  
Epstein Barr

Virus Epstein Barr (VEB) ha sido relacionado con una serie de tumores malignos de origen epitelial y linfoide. Existe una clara correlación entre este virus y enfermedades linfoproliferativas como Linfoma de Burkitt (LB), Linfoma Hodgkin (LH), Linfoma no Hodgkin (LNH) y carcinoma gástrico. Se han desarrollado diversas técnicas para la detección de VEB en células tumorales: hibridación in situ (RISH) que detecta RNAs (ácido ribonucleico) pequeños codificados para VEB (EBERs) en las células con infección latente, considerado el estándar de oro para la identificación del virus; la reacción en cadena de la polimerasa (PCR) que permite la detección de la cepa viral y representa un ensayo importarte en el diagnóstico del virus. Se realizó un estudio retrospectivo a partir de muestras de tejidos en parafina de pacientes con linfoma y se buscó al virus mediante PCR y RISH. La prevalencia del virus fue de 58,82%, el género más afectado fue el masculino y el grupo más afectado fue el de 31/40 años. La presencia del virus fue similar en ambos tipos de linfoma: Hodking y No Hodking. La técnica de RISH se mostró más eficiente para detectar la presencia del virus. AbstractEpstein Barr Virus (EBV) is linked to a number of malignant tumors of epithelial and lymphoid origin. There is a strong correlation between this virus and lymphoproliferative diseases such as Burkitt's lymphoma (BL), Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL) and gastric carcinoma. There are various techniques developed to detect EBV in tumor cells: in situ hybridization (ISH) detects small coded RNAs (ribonucleic acid) to VEB (EBERs) in latently infected cells. This is considered the gold standard for virus identification. The polymerase chain reaction (PCR) allows the detection of the viral strain and represents an important fact in the virus diagnose. We conducted a retrospective study in paraffin from tissue samples of patients with lymphoma and we sought the virus through PCR and RISH. The virus prevalence was 58.82%, the most affected gender was male and the most affected group was 31/40 years. The virus was similar in both types of lymphoma: Hodgkin and non-Hodgkin. RISH technique seemed to be more efficient to detect the virus.

Immunosuppression and other risk factors for early and late non-Hodgkin lymphoma after kidney transplantation

Blood ◽  
2009 ◽  
Vol 114 (3) ◽  
pp. 630-637 ◽  
Author(s):  
Marina T. van Leeuwen ◽  
Andrew E. Grulich ◽  
Angela C. Webster ◽  
Margaret R.E. McCredie ◽  
John H. Stewart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Hodgkin Lymphoma ◽  
Calcineurin Inhibitors ◽  
Kidney Transplant Recipients ◽  
Barr Virus ◽  
Non Hodgkin Lymphoma ◽  
Transplant Function ◽  
Epstein Barr ◽  
Rate Ratios

Abstract Non-Hodgkin lymphoma (NHL) incidence is greatly increased after kidney transplantation. NHL risk was investigated in a nationwide cohort of 8164 kidney transplant recipients registered on the Australia and New Zealand Dialysis and Transplant Registry. NHL diagnoses were ascertained using linkage with national cancer registry records. Multivariate Poisson regression was used to compute incidence rate ratios (IRRs) with 95% confidence intervals (CIs) comparing risk by transplant function, and risk factors for early (< 2 years) and late (≥ 2 years) NHL during the first transplantation. NHL occurred in 133 patients. Incidence was strikingly lower after transplant failure and cessation of immunosuppression than during transplant function (IRR, 0.25; 95% CI, 0.08-0.80; P = .019). Early NHL (n = 27) was associated with Epstein-Barr virus (EBV) seronegativity at transplantation (IRR, 4.66; 95% CI, 2.10-10.36, P < .001) and receipt of T cell–depleting antibodies (IRR, 2.39; 95% CI, 1.08-5.30; P = .031). Late NHL (n = 79) was associated with increasing year of age (IRR, 1.02; 95% CI, 1.01-1.04; P = .006), increasing time since transplantation (P < .001), and current use of calcineurin inhibitors (IRR, 3.13; 95% CI, 1.53-6.39; P = .002). These findings support 2 mechanisms of lymphomagenesis, one predominantly of primary EBV infection in the context of intense immunosuppression, and another of dysregulated lymphoid proliferation in a prolonged immunosuppressed state.

scholarly journals Management of older Hodgkin lymphoma patients

Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 233-242 ◽  
Author(s):  
Andrew M. Evens ◽  
Jordan Carter ◽  
Kah Poh Loh ◽  
Kevin A. David
Keyword(s):  
Functional Status ◽  
Hodgkin Lymphoma ◽  
Survival Rates ◽  
Brentuximab Vedotin ◽  
Disease Stage ◽  
Advanced Stage ◽  
Curative Intent ◽  
Younger Patients ◽  
Barr Virus ◽  
Epstein Barr

Abstract Hodgkin lymphoma (HL) in older patients, commonly defined as ≥60 years of age, is a disease for which survival rates have historically been significantly lower compared with younger patients. Older HL patients appear to have different disease biology compared with younger patients, including increased incidence of mixed cellularity histology, Epstein-Barr virus–related, and advanced-stage disease. For prognostication, several studies have documented the significance of comorbidities and functional status in older HL patients, as well as the importance of achieving initial complete remission. Collectively, selection of therapy for older HL patients should be based in part on functional status, including pretreatment assessment of activities of daily living (ADL), comorbidities, and other geriatric measures (eg, cognition, social support). Treatment of fit older HL patients should be given with curative intent, regardless of disease stage. However, attention should be paid to serious treatment-related toxicities, including risk of treatment-related mortality. Although inclusion of anthracycline therapy is important, bleomycin-containing regimens (eg, doxorubicin, bleomycin, vinblastine, dacarbazine) may lead to prohibitive pulmonary toxicity, and intensive therapies (eg, bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) are too toxic. Brentuximab vedotin given sequentially before and after doxorubicin, vinblastine, and dacarbazine to fit, untreated advanced-stage older HL patients was recently shown to be tolerable and highly effective. Therapy for patients who are unfit or frail because of comorbidities and/or ADL loss is less clear and should be individualized with consideration of lower-intensity therapy, such as brentuximab vedotin with or without dacarbazine. Altogether, therapy for older HL patients should be tailored based upon a geriatric assessment, and novel targeted agents should continue to be integrated into treatment paradigms.

scholarly journals Checkpoint inhibition and cellular immunotherapy in lymphoma

Hematology ◽  
2016 ◽  
Vol 2016 (1) ◽  
pp. 390-396 ◽  
Author(s):  
Premal Lulla ◽  
Helen E. Heslop
Keyword(s):  
T Cells ◽  
Hodgkin Lymphoma ◽  
Tumor Antigens ◽  
Response Rates ◽  
Cellular Immunotherapy ◽  
Clinical Activity ◽  
Antigen Receptors ◽  
Barr Virus ◽  
Non Hodgkin Lymphoma ◽  
Epstein Barr

Abstract Hodgkin and non-Hodgkin lymphoma are both good targets for immunotherapy, as they are accessible to antibodies and cell-based immunotherapy, express costimulatory molecules, and express lineage-restricted, viral, and unique tumor antigens. Blockade of the programmed-death 1 (PD-1) immune checkpoint has produced very encouraging response rates in patients with Hodgkin lymphoma, whereas adoptive transfer of Epstein-Barr Virus (EBV)-specific T cells has shown clinical activity in patients with posttransplant lymphoma and other EBV-associated lymphomas. T cells can also be genetically modified with chimeric antigen receptors (CARs) to confer specificity for surface antigens, and studies of CD19 CARs in lymphoma also have had encouraging response rates. Future directions include combination of checkpoint blockade and adoptive T-cell studies.

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