HIV-Associated Plasmablastic Lymphoma Following HAART-Related Immune Reconstitution

Pantanowitz, Liron; Doweiko, John P.; Bráza, J; Pihán, Germán; Dezube, Bruce J.

doi:10.1016/s1730-1270(10)60049-5

Cited by 2 publications

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“…In addition, latent Epstein-Barr virus (EBV) infection is detected in a majority (70%) of PBL cases [ 9 ]. The association between PBL and cryptococcal infection, however, is poorly studied and limited to a few case reports [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Cutaneous Plasmablastic Lymphoma in HIV/AIDS with DisseminatedCryptococcus

Gong

Alkan

Anand

2013

Case Reports in Oncological Medicine

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We present a case of a patient with HIV/AIDS who presented with a tender left lower extremity cutaneous mass over a site of previous cryptococcal infection and was found to have plasmablastic lymphoma (PBL). The incidence of PBL is estimated to account for less than 5% of all cases of non-Hodgkin lymphoma (NHL) in HIV-positive individuals. In fact, there were only two reports of extraoral PBL at the time of a 2003 review. PBL in HIV-positive individuals is an aggressive malignancy that tends to occur in middle-aged males with low CD4 counts, high viral loads, and chronic HIV infection. The definitive diagnosis can be made with biopsy which typically shows malignant lymphoid cells that stain positive for plasma cell markers and negative for B-cell markers. The most common treatment is chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens, but the overall survival rate is poor despite its relative responsiveness to chemotherapy. This case highlights the challenges that remain in improving clinical outcomes, the importance of antiretroviral therapy and HIV disease control, and a potential association between a chronic inflammatory state caused by disseminated Cryptococcus and tumorigenesis in individuals with PBL.

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Section: Discussionmentioning

confidence: 99%

A Case of Cutaneous Plasmablastic Lymphoma in HIV/AIDS with DisseminatedCryptococcus

Gong

Alkan

Anand

2013

Case Reports in Oncological Medicine

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HIV‐associated plasmablastic lymphoma: Lessons learned from 112 published cases

2008

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Plasmablastic lymphoma (PBL) is a distinct subtype of non-Hodgkin B-cell lymphoma, originally described with a strong predilection to the oral cavity of human immunodeficiency virus (HIV)-infected individuals. Data regarding patient age and gender, HIV status, initiation of and response to highly active antiretroviral therapy (HAART), tumor extent, pathology, treatment, and outcome were extracted from 112 cases of PBL identified in the literature. The median age at presentation was 38 years with a male predominance of 7:1, and the median CD41 count was 178 cells/mm 3 . PBL presented on average 5 years after diagnosis of HIV. Common primary sites of presentation included the oral cavity, gastrointestinal tract, and lymph nodes. Most cases presented with either stage I or stage IV disease. There was a variable expression of B-cell markers in tumor cells, but plasma cell markers were expressed in all cases. EBV was detected in 74%. Chemotherapy was used to treat 55% patients and was combined with radiotherapy in 21% cases. Complete response was obtained in 66% of treated cases; the majority of these responses were seen after CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone). The refractory/relapsed disease rate was 54%. Death occurred in 53% of patients, with a median overall survival of 15 months. Sex, CD41 count, viral load, clinical stage, EBV status, primary site of involvement, and use of CHOP failed to show an association with survival. PBL is an aggressive B-cell lymphoma that presents in both oral and extra-oral sites of chronically HIV-infected immunosuppressed young men. Am. J. Hematol. 83:804-809, 2008. V

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HIV-Associated Plasmablastic Lymphoma Following HAART-Related Immune Reconstitution

Cited by 2 publications

References 10 publications

A Case of Cutaneous Plasmablastic Lymphoma in HIV/AIDS with DisseminatedCryptococcus

A Case of Cutaneous Plasmablastic Lymphoma in HIV/AIDS with DisseminatedCryptococcus

HIV‐associated plasmablastic lymphoma: Lessons learned from 112 published cases

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