Christian Hoffmann1, Philipp Schommers, Eva Wolf, Markus Müller, Alexander Schultze, Ivanka Krznaric, Albrecht Stoehr, Timo Wolf, Gerd Fäktenheuer, Bastian Stier, Christoph Wyen, Marcus Hentrich. 1. aICH Study Center Hamburg bDepartment of Medicine II, University of Schleswig-Holstein, Campus Kiel cDepartment I of Internal Medicine, University Hospital Cologne, Cologne dMUC Research, Munich eDepartment of Infectious Diseases, Vivantes Auguste-Viktoria-Hospital, Berlin fDepartment of Hematology, Oncology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Comprehensive Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg gMedical Center for Infectious Diseases (MIB), Berlin hIfi-Institute for Interdisciplinary Medicine, Hamburg iDepartment of Medicine II, University of Frankfurt, Frankfurt j German Centre for Infection Research (DZIF), Cologne kDepartment of Medicine III, Red Cross Hospital Munich, Munich, Germany. *Christian Hoffmann and Philipp Schommers contributed equally to the writing of this article. †Christoph Wyen and Marcus Hentrich share senior authorship.
Abstract
OBJECTIVE: The risk of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) is increased in HIV-infected individuals. We studied the kinetics of lymphocyte subsets in patients who subsequently developed HL or NHL while on virologically suppressive antiretroviral therapy (ART). DESIGN: Using a nested case-control design, cases of HIV+ HL or NHL were selected from two prospective clinical studies. Aviremia was defined as less than 200 HIV-RNA copies/ml for at least 6 months prior to lymphoma diagnosis. Each case was matched to three aviremic HIV+ controls without lymphoma. RESULTS: In the 81 cases (50 HL and 31 NHL), prediagnostic CD4 T cells and CD8 T cells displayed discordant kinetics compared with controls. Within the last and within the next-to-last year preceding HL diagnosis, mean CD4 T cells decreased by -168 and by -2 cells/μl, compared with an increase of +44 and +73 cells/μl in the controls, respectively. Mean CD8 T cells decreased by -352 and -115 cells/μl, compared with nonsignificant changes of -29 and ±0 cells/μl in the controls, respectively. T-cell kinetics demonstrated a marked inter-individual variability. Kinetics of CD4 and CD8 T cells were also discordant between NHL cases and controls. CONCLUSION: This study on a large number of aviremic patients developing HL and NHL who were carefully matched with controls, gives insights to prediagnostic kinetics of immune parameters. The discordant kinetics of both CD4 and CD8 T cells are already seen 1-2 years prior to lymphoma diagnosis, are more pronounced during the last year and in patients developing HL but are also seen in NHL.
OBJECTIVE: The risk of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) is increased in HIV-infected individuals. We studied the kinetics of lymphocyte subsets in patients who subsequently developed HL or NHL while on virologically suppressive antiretroviral therapy (ART). DESIGN: Using a nested case-control design, cases of HIV+ HL or NHL were selected from two prospective clinical studies. Aviremia was defined as less than 200 HIV-RNA copies/ml for at least 6 months prior to lymphoma diagnosis. Each case was matched to three aviremic HIV+ controls without lymphoma. RESULTS: In the 81 cases (50 HL and 31 NHL), prediagnostic CD4 T cells and CD8 T cells displayed discordant kinetics compared with controls. Within the last and within the next-to-last year preceding HL diagnosis, mean CD4 T cells decreased by -168 and by -2 cells/μl, compared with an increase of +44 and +73 cells/μl in the controls, respectively. Mean CD8 T cells decreased by -352 and -115 cells/μl, compared with nonsignificant changes of -29 and ±0 cells/μl in the controls, respectively. T-cell kinetics demonstrated a marked inter-individual variability. Kinetics of CD4 and CD8 T cells were also discordant between NHL cases and controls. CONCLUSION: This study on a large number of aviremic patients developing HL and NHL who were carefully matched with controls, gives insights to prediagnostic kinetics of immune parameters. The discordant kinetics of both CD4 and CD8 T cells are already seen 1-2 years prior to lymphoma diagnosis, are more pronounced during the last year and in patients developing HL but are also seen in NHL.
Authors: Francisco J Hernández-Walias; Esther Vázquez; Yolanda Pacheco; José M Rodríguez-Fernández; María J Pérez-Elías; Fernando Dronda; José L Casado; Ana Moreno; José M Hermida; Carmen Quereda; Asunción Hernando; Francisco Tejerina-Picado; Víctor Asensi; María J Galindo; Manuel Leal; Santiago Moreno; Alejandro Vallejo Journal: J Clin Med Date: 2020-03-11 Impact factor: 4.241