Human immunodeficiency virus-associated plasmablastic lymphoma: Poor prognosis in the era of highly active antiretroviral therapy

Jorge J. Castillo, Michael Furman, Brady E. Beltrán, Michele Bibas, Mark Bower, Weina Chen, José L. Díez-Martín, Jane J. Liu, Roberto N. Miranda, Silvia Montoto, Nahid M. Nanaji, José Tomás Navarro, Adam C. Seegmiller, Julie M. Vose

Research output: Contribution to journalArticlepeer-review

84 Scopus citations

Abstract

Background: Plasmablastic lymphoma (PBL) is a rare and aggressive B-cell lymphoma strongly associated with human immunodeficiency virus (HIV) infection. The authors conducted a multi-institutional, retrospective study to describe characteristics and determine prognostic factors in HIV-associated PBL. Methods: For this study, the investigators included consecutive, HIV-positive patients diagnosed between the years 2000 and 2010 whose tumors had a plasmablastic morphology, were cluster of differentiation 20 (CD20)-negative, and expressed markers of plasmacytic differentiation. Results: Fifty patients from 13 institutions were evaluated. The median age was 43 years, and there was a male predominance. The median count of cells that were positive for CD4 (a glycoprotein expressed on the surface of T-helper cells, monocytes, macrophages, and dendritic cells) was 206 cells/mm3. At presentation, 90% of patients had extranodal involvement, 69% presented with advanced stage disease, and 27% had oral involvement. Rearrangements of v-myc myelocytomatosis viral oncogene homolog (MYC) were detected in 41% of the tested patients. Eighty-five percent of patients received chemotherapy, with 63% receiving cyclophosphamide, doxorubicin, vincristine, and prednisone and 37% receiving more intensive regimens. The complete response (CR) rate was 66%. The median overall survival (OS) was 11 months regardless of the intensity of chemotherapy. In the survival analysis, an Eastern Cooperative Oncology Group performance status ≥2, advanced stage, and MYC rearrangements were associated significantly with a worse outcome, whereas attaining a CR with chemotherapy was associated with a better outcome. Conclusions: The prognosis of PBL in HIV-infected individuals remains poor in the highly active antiretroviral therapy era. Intensive chemotherapy regimens do not seem to increase survival in patients with HIV-associated PBL. Cancer 2012.

Original languageEnglish (US)
Pages (from-to)5270-5277
Number of pages8
JournalCancer
Volume118
Issue number21
DOIs
StatePublished - Nov 1 2012

Keywords

  • acquired immunodeficiency syndrome
  • chemotherapy
  • highly active antiretroviral therapy
  • human immunodeficiency virus
  • plasmablastic

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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