Joseph A Sparano1. 1. Albert Einstein College of Medicine, Department of Oncology, Montefiore Medical Center, Weiler Division, Bronx, New York 10461, USA. jsparano@montefiore.org
Abstract
PURPOSE OF THE REVIEW: The aim of this article is to review key reports regarding the biology and management of HIV-associated lymphoma during the past year. RECENT FINDINGS: The use of highly active antiretroviral therapy (HAART) has been associated with a reduced risk of primary cerebral and systemic non-Hodgkin's lymphoma, a stable or slightly increased risk of Hodgkin's lymphoma, and improved prognosis for those who develop HIV-associated non-Hodgkin's lymphoma or Hodgkin's lymphoma. Emerging evidence suggests that patients with HIV-associated lymphoma should be treated in a similar manner as immunocompetent patients with the same disease, especially if the CD4 count is 50-100 cells/mul or higher. Use of the anti-CD20 monoclonal antibody rituximab in combination with chemotherapy appears to result in improved control of B-cell lymphoma, but may come at the expense of an increased risk of bacterial and viral infections. SUMMARY: Although the evidence currently supports an aggressive and curative approach for the management of HIV-associated lymphoma, clinicians must be vigilant about implementing infection prophylaxis and promptly recognizing, diagnosing, and treating bacterial, parasitic, fungal, and viral infections that may occur as a consequence of therapy.
PURPOSE OF THE REVIEW: The aim of this article is to review key reports regarding the biology and management of HIV-associated lymphoma during the past year. RECENT FINDINGS: The use of highly active antiretroviral therapy (HAART) has been associated with a reduced risk of primary cerebral and systemic non-Hodgkin's lymphoma, a stable or slightly increased risk of Hodgkin's lymphoma, and improved prognosis for those who develop HIV-associated non-Hodgkin's lymphoma or Hodgkin's lymphoma. Emerging evidence suggests that patients with HIV-associated lymphoma should be treated in a similar manner as immunocompetent patients with the same disease, especially if the CD4 count is 50-100 cells/mul or higher. Use of the anti-CD20 monoclonal antibody rituximab in combination with chemotherapy appears to result in improved control of B-cell lymphoma, but may come at the expense of an increased risk of bacterial and viral infections. SUMMARY: Although the evidence currently supports an aggressive and curative approach for the management of HIV-associated lymphoma, clinicians must be vigilant about implementing infection prophylaxis and promptly recognizing, diagnosing, and treating bacterial, parasitic, fungal, and viral infections that may occur as a consequence of therapy.
Authors: S K Barta; M S Samuel; X Xue; D Wang; J Y Lee; N Mounier; J-M Ribera; M Spina; U Tirelli; R Weiss; L Galicier; F Boue; R F Little; K Dunleavy; W H Wilson; C Wyen; S C Remick; L D Kaplan; L Ratner; A Noy; J A Sparano Journal: Ann Oncol Date: 2015-01-28 Impact factor: 32.976
Authors: Stefan K Barta; Xiaonan Xue; Dan Wang; Roni Tamari; Jeannette Y Lee; Nicolas Mounier; Lawrence D Kaplan; Josep-Maria Ribera; Michele Spina; Umberto Tirelli; Rudolf Weiss; Lionel Galicier; Francois Boue; Wyndham H Wilson; Christoph Wyen; Albert Oriol; José-Tomás Navarro; Kieron Dunleavy; Richard F Little; Lee Ratner; Olga Garcia; Mireia Morgades; Scot C Remick; Ariela Noy; Joseph A Sparano Journal: Blood Date: 2013-09-06 Impact factor: 22.113
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Authors: Amy Chadburn; April Chiu; Jeannette Y Lee; Xia Chen; Elizabeth Hyjek; Alison H Banham; Ariela Noy; Lawrence D Kaplan; Joseph A Sparano; Kishor Bhatia; Ethel Cesarman Journal: J Clin Oncol Date: 2009-09-14 Impact factor: 44.544
Authors: Joseph A Sparano; Jeannette Y Lee; Lawrence D Kaplan; Juan Carlos Ramos; Richard F Ambinder; William Wachsman; David Aboulafia; Ariela Noy; David H Henry; Lee Ratner; Ethel Cesarman; Amy Chadburn; Ronald Mitsuyasu Journal: Haematologica Date: 2021-03-01 Impact factor: 9.941