Clinical and pathological differences between human immunodeficiency virus-positive and human immunodeficiency virus-negative patients with plasmablastic lymphoma

Abstract

Plasmablastic lymphoma (PBL) is a distinct variant of diffuse large B-cell lymphoma initially described in HIV-positive patients. Several studies have reported the occurrence of PBL in HIV-negative patients, but comparative data are lacking. The goal of this study was to compare the characteristics of HIV-positive and HIV-negative patients with PBL. A MEDLINE search was undertaken through August 2009 for cases of PBL in HIV-positive and HIV-negative patients. Cases were identified and clinicopathological data were gathered. χ(2) was used to compare categorical and t-test to compare continuous variables between groups. Calculated Kaplan-Meier survival estimates were compared using the log-rank test. Cox proportional-hazard regression was used for multivariate analysis. From 228 identified cases of PBL, 157 were HIV-positive and 71 HIV-negative. HIV-positive patients were younger, and more likely to be men, present with oral involvement, respond to chemotherapy, and express CD20, CD56, and EBV-encoded RNA than HIV-negative patients. In univariate analysis, age ≥60, advanced stage, bone marrow involvement, no chemotherapy, Ki-67 expression >80%, and HIV-negative status were associated with worse overall survival. In multivariate analysis, advanced stage and no chemotherapy were independent adverse prognostic factors. In conclusion, HIV-positive and HIV-negative patients with PBL have different clinicopathological characteristics, including a better response to chemotherapy and longer survival in HIV-positive patients.

Clinicopathologic features of plasmablastic lymphoma: Single-center series of 8 cases from Saudi Arabia

“…The significant value of association between EBV expression and PBL cases is unclear. Some studies have shown a better outcome in immunocompetent patients with PBL, while others have shown that EBV expression is not associated with the Ki-67 outcome of HIV-associated PBL [36][37][38]. In brief, our results (though the sample size is small) shows that EBV infection is not the sole cause of the disease.…”

HIV-associated non-Hodgkin lymphoma: viral origins and therapeutic options

“…13 Morphologically, cells have features of DLBCL, but usually lack CD20 and CD45 expression. However, HIV-1-positive PBL tends to be more commonly CD20-positive than the HIV-1-negative cases, and this has led to the theory that the HIV-1-positive PBL arises from a B cell at earlier stages of plasmacytic differentiation.…”

Plasmablastic lymphoma of the anus: a case report

“…Hansara et al reported a better overall survival in patients with PBL of extra-oral sites when compared to patients with oral PBL [10] . Some authors have described a better prognosis in HIV positive patients with PBL as compared to HIV negative patients with PBL [14] . In HIV patients HAART administration and immunosurveillance restoration correlate with better survival.…”