Prognostic Factors and Outcome of Human Herpesvirus 8–Associated Primary Effusion Lymphoma in Patients With AIDS

Abstract

Based on a retrospective series of 28 patients, two prognostic factors were identified as being independently associated with impaired clinical outcome in HIV-related PEL--(1) a poor performance status and (2) the absence of HAART before PEL diagnosis.

Primary Effusion Lymphoma Diagnosed by Pericardiocentesis

“…In addition, some case reports have documented long-term survival with HAART alone (15,16). The most recent multicenter series of 28 patients showed a median survival time of 6.2 months and 1-year overall survival of 39.3%, which is similar to results from small patient series (17). In that multicenter study, Boulanger et al concluded that the only two negative prognostic factors in HIV-related PEL were poor performance status and absence of HAART prior to PEL diagnosis.…”

Pulmonary manifestations of human herpesvirus-8 during HIV infection

“…Lactate dehydrogenase concentration is, in general, elevated [27]. Bone-marrow biopsy may show haemophagocytosis but rarely tumour cells [24,27].…”

“…Pleural effusion is present in 85% of cases and is associated with ascites in 50% of cases [24]. PEL may also be revealed by a cardiac tamponade secondary to a specific pericardial localisation [27].…”

“…Enlarged peripheral lymph nodes are rare. Neurological deficit or a maxillary lesion should lead to suspicion of the specific localisation of the disease [24]. Biological examination often reveals anaemia, associated in 50% of cases, with thrombocytopenia and hypoalbuminaemia [24].…”

“…Cells infected with HHV-8 may be identified by immunohistochemistry, because they express latency-associated nuclear antigen (LANA). Real-time PCR provides a quantitative approach to analyse HHV-8 viral load and results are correlated with the number of infected cells and type of disease [10,24].…”