HIV-1–related Hodgkin lymphoma in the era of combination antiretroviral therapy: incidence and evolution of CD4+ T-cell lymphocytes

Bohlius, Julia; Schmidlin, Kurt; Boué, François; Fätkenheuer, Gerd; May, Margaret; Caro-Murillo, Ana María; Mocroft, Amanda; Bonnet, Fabrice; Clifford, Gary M.; Paparizos, Vassilios; Miró, José M.; Obel, Niels; Prins, Maria; Chêne, Geneviève; Egger, Matthias

doi:10.1182/blood-2010-08-301531

Cited by 102 publications

(84 citation statements)

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“…4 This observation was possible because CD4 þ T-cell blood counts in HIV-patients are usually well documented. It can be expected that HIV-negative individuals will react in the same manner, although this has not been documented.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Although HIV-related classical Hodgkin lymphoma occurs at any CD4 blood count, it is most frequently observed in patients with a moderate immune deficiency and CD4 blood counts of 150-249 cells/ml. 2,4 As Hodgkin-and Reed-Sternberg cells, the tumor cells in classical Hodgkin lymphoma, usually constitute a small subpopulation of the cells in affected lymph nodes; it is likely that the microenvironment, largely composed of CD4 þ T regulatory 1 cells, has an essential role in the pathophysiology of the disease. 5 As HIV infection usually involves decreased CD4 þ T-cell counts in the peripheral blood, several studies have addressed the issue of the microenvironment in HIV-associated Hodgkin lymphoma and have found the CD4/CD8 T-cell ratio to be inverted.…”

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confidence: 99%

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Spindle-shaped CD163+ rosetting macrophages replace CD4+ T-cells in HIV-related classical Hodgkin lymphoma

et al. 2013

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Combination antiretroviral therapy is highly effective in HIV infection, leading to decreased incidences of AIDSdefining neoplasms. However, HIV patients still have a 10-fold increased risk of developing classical Hodgkin lymphoma compared with the general population. As Hodgkin-and Reed-Sternberg cells represent only a minority in the tumor infiltrate, the aim of the present study was to characterize the microenvironment of HIV-related classical Hodgkin lymphoma and compare it with classical Hodgkin lymphoma cases of immunocompetent individuals. The major morphologic differences were the presence of necrotic foci and the absence of epithelioid cell formation in HIV-related Hodgkin lymphoma. We observed a significantly decreased number of CD4 þ T-cells and a significantly increased number of CD163 þ macrophages in HIVrelated Hodgkin lymphoma. Cases exhibiting a 'sarcomatoid' pattern of the reactive infiltrate exhibited significantly greater numbers of macrophages, associating the 'sarcomatoid' pattern to the presence of spindle-shaped macrophages. Whereas, rosetting of CD4 þ T-cells around Hodgkin-and Reed-Sternberg cells was frequently observed in classical Hodgkin lymphoma in immunocompetent persons; rosetting in a subset of HIV-related Hodgkin lymphoma cases appeared to involve cytoplasmic protrusions of spindle-shaped macrophages. HIV-related Hodgkin lymphoma, therefore, is characterized by unique morphologic features, which should be recognized by pathologists.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Spindle-shaped CD163+ rosetting macrophages replace CD4+ T-cells in HIV-related classical Hodgkin lymphoma

et al. 2013

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“…1 A recent analysis of combined European cohorts of HIV-infected individuals has revealed that combination antiretroviral therapy (cART) reduces the incidence of HL. 2 The optimal treatment for patients with immunocompetent HL continues to evolve. In randomized, controlled studies that include immunocompetent patients with classical HL, it has been demonstrated that the combination of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) is effective and is probably less toxic than more intensive regimens.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for advanced‐stage human immunodeficiency virus‐associated classical Hodgkin lymphoma treated with doxorubicin, bleomycin, vinblastine, and dacarbazine plus combined antiretroviral therapy: A multi‐institutional retrospective study

Castillo

Bower

Brühlmann

et al. 2014

Cancer

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; for the HIV-Associated Hodgkin Lymphoma in the cART Era Study Group BACKGROUND: The treatment and outcomes of patients with human immunodeficiency virus (HIV)-associated Hodgkin lymphoma (HL) continue to evolve. The International Prognostic Score (IPS) is used to predict the survival of patients with advanced-stage HL, but it has not been validated in patients with HIV infection. METHODS: This was a multi-institutional, retrospective study of 229 patients with HIV-associated, advanced-stage, classical HL who received doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus combination antiretroviral therapy. Their clinical characteristics were presented descriptively, and multivariate analyses were performed to identify the factors that were predictive of response and prognostic of progression-free survival (PFS) and overall survival (OS). RESULTS: The overall and complete response rates to ABVD in patients with HIV-associated HL were 91% and 83%, respectively. After a median follow-up of 5 years, the 5-year PFS and OS rates were 69% and 78%, respectively. In multivariate analyses, there was a trend toward an IPS score >3 as an adverse factor for PFS (hazard ratio [HR], 1.49; P5.15) and OS (HR, 1.84; P5.06). A cluster of differentiation 4 (CD4)-positive (T-helper) cell count <200 cells/lL was associated independently with both PFS (HR, 2.60; P5.002) and OS (HR, 2.04; P5.04). The CD4-positive cell count was associated with an increased incidence of death from other causes (HR, 2.64; P5.04) but not with death from HL-related causes (HR, 1.55; P5.32). CONCLUSIONS: The current results indicate excellent response and survival rates in patients with HIV-associated, advanced-stage, classical HL who receive ABVD and

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“…Patients whose CD4 cell counts declined despite suppression of HIV-1 replication on cART were at increased risk of Hodgkin's lymphoma. 29 Comparative analyses are planned in collaboration with the African regions of IeDEA. 4 …”

Section: Opportunistic Infectionsmentioning

confidence: 99%

“…1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 The COHERE malignancy group has focused on defining the incidence, risk factors and prognosis of HIV-associated cancers in the cART era, with a focus on systemic non-Hodgkin lymphoma (NHL) and primary brain lymphoma (PBL), Hodgkin's lymphoma and, more recently, Kaposi's sarcoma. [28][29][30] The incidence of non-Hodgkin's lymphoma, primary brain lymphoma and Kaposi's sarcoma were substantially reduced in patients on cART, and timely initiation of therapy at high CD4 cell counts is important for preventing these malignancies. 28,30 In contrast, the incidence of Hodgkin's lymphoma was not reduced by cART.…”

Section: Opportunistic Infectionsmentioning

confidence: 99%

Cohort Profile: Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord

Chêne

Phillips²,

Costagliola

et al. 2016

Int. J. Epidemiol.

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HIV-1–related Hodgkin lymphoma in the era of combination antiretroviral therapy: incidence and evolution of CD4+ T-cell lymphocytes

Abstract: The risk of Hodgkin lymphoma (HL) is in-

Cited by 102 publications

References 45 publications

Spindle-shaped CD163+ rosetting macrophages replace CD4+ T-cells in HIV-related classical Hodgkin lymphoma

Spindle-shaped CD163+ rosetting macrophages replace CD4+ T-cells in HIV-related classical Hodgkin lymphoma

Prognostic factors for advanced‐stage human immunodeficiency virus‐associated classical Hodgkin lymphoma treated with doxorubicin, bleomycin, vinblastine, and dacarbazine plus combined antiretroviral therapy: A multi‐institutional retrospective study

Cohort Profile: Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord

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