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Short communication: spectrum of non-Hodgkin lymphoma in an urban Ryan White-funded clinic in the established antiretroviral era.
[primary effusion lymphoma]
People
living
with
HIV
/
AIDS
(
PLWHA
)
are
at
a
higher
risk
of
developing
non-
Hodgkin
lymphoma
(
NHL
)
.
The
influence
of
combined
antiretrovirals
(
cART
)
on
the
presentation
,
treatment
,
and
outcomes
of
HIV-associated
NHL
(
HIV-NHL
)
warrants
further
investigation
.
We
performed
a
retrospective
analysis
of
PLWHA
diagnosed
with
NHL
who
received
care
at
the
Infectious
Diseases
Ponce
de
Leon
Center
in
Atlanta
,
Georgia
,
from
January
1
,
2004
to
December
31
,
2010
.
Thirty
-
five
patients
with
HIV-NHL
were
identified
.
Among
these
patients
,
7
had
Burkitt
lymphoma
(
BL
)
,
20
had
diffuse
large
B
cell
lymphoma
(
DLBCL
)
,
7
had
plasmablastic
lymphoma
(
PL
)
,
and
1
had
primary
effusion
lymphoma
(
PEL
)
.
The
majority
of
patients
(
82
.
9
%
)
presented
with
advanced
disease
,
and
63
%
were
not
on
ART
at
diagnosis
.
Despite
having
good
performance
status
at
presentation
,
the
majority
of
patients
presented
with
high
International
Prognostic
Index
(
IPI
)
scores
.
There
were
differences
between
the
histologic
subtypes
of
NHL
in
regard
to
treatment
,
complications
,
and
outcomes
.
The
median
CD
4
lymphocyte
count
at
diagnosis
was
110
cells
/
mm
(
3
)
for
patients
with
DLBCL
[
interquartile
range
(
IQR
)
:
66
,
203
]
,
165
cells
/
mm
(
3
)
for
Burkitt
lymphoma
(
IQR
:
36
,
199
)
,
and
98
cells
/
mm
(
3
)
for
plasmablastic
lymphoma
(
IQR
:
34
,
214
)
.
Overall
,
patients
completed
67
%
of
planned
chemotherapy
cycles
.
Common
causes
for
chemotherapy
termination
were
persistent
myelosuppression
(
18
.
2
%
)
,
social
factors
(
22
.
7
%
)
,
and
disease
progression
(
36
.
4
%
)
.
Social
factors
included
lack
of
transportation
,
substance
abuse
,
unstable
housing
,
and
poor
adherence
.
Two
-
year
overall
survival
was
40
%
for
all
HIV-NHL
.
Half
of
the
patients
with
DLBCL
(
n
=
10
)
,
42
%
of
patients
with
PL
(
n
=
3
)
,
and
only
14
.
3
%
of
patients
with
BL
(
n
=
1
)
were
alive
at
2
years
.
Among
the
overall
survivors
at
2
years
,
85
.
7
%
had
CD
4
>
200
cells
/
mm
(
3
)
and
78
.
6
%
had
undetectable
HIV
viral
loads
(
VL
)
at
that
time
.
Diseases
Validation
Diseases presenting
"established antiretroviral era.people"
symptom
primary effusion lymphoma
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