Successful administration of aggressive chemotherapy concomitant to tuberculostatic and highly active antiretroviral therapy in a patient with AIDS‐related Burkitt's lymphoma

Abstract

Treatment of AIDS‐related malignant lymphoma (ARL) remains a therapeutic challenge. There are concerns not only about infectious and haematological complications in HIV‐infected patients during intensive chemotherapy, but also about potential interactions between chemotherapy and highly active antiretroviral therapy (HAART). Current data on patients treated concomitantly with intensive chemotherapy and HAART are limited, and no data exist on patients with ARL suffering from active opportunistic infections. We report the case of a 38‐year‐old man with advanced HIV‐1 infection, pulmonary tuberculosis and Burkitt's lymphoma. Intensive chemotherapy was administered in parallel with tuberculostatic therapy and HAART. Six months later, the patient achieved not only a complete remission of Burkitt's lymphoma and sustained viral suppression, but also a full recovery from tuberculosis. This case report provides some useful observations on the successful application of intensive chemotherapy in addition to tuberculostatic therapy and HAART in HIV‐infected patients.

Biology and treatment of Burkittʼs lymphoma

“…Although previous reports have focused for the most part on the sporadic form of Burkitt's lymphoma, many of these same regimens and advances are being studied in immunodeficient/HIV-associated Burkitt's lymphoma [43,[58][59][60]. There is some controversy as to whether highly active antiretroviral therapy has significantly decreased the incidence of immunodeficient Burkitt's lymphoma [61][62][63].…”

Mantle cell lymphoma involvement of the pleura and tuberculous pleurisy with pulmonary tuberculosis: a case report and literature review

“…Keywords used in various combinations were ''tuberculosis,'' ''lymphoma,'' ''co-existence,'' and ''concurrently.'' Including our present case, 17 cases were reported (Table 2) [11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Fourteen of the 17 cases were pulmonary tuberculosis or lymph node tuberculosis.…”

Unmasked tuberculosis or lymphoma in late AIDS presenters: a difficult differential diagnosis

“…These two case reports represent two unusual presentation of AIDS-defining illnesses in which the complex interplay and mutual masking between an underlying opportunistic infection and host immune-haematological response could render the differential diagnosis a critical task for the clinician. Aggressive diagnostic and treatment efforts should be engaged to achieve possible recovery of these severe syndromes [10].…”