A new prognostic score for AIDS-related lymphomas in the rituximab-era

Barta, Stefan K.; Xue, Xiaonan; Wang, Dan; Lee, Jeannette; Kaplan, Lawrence D.; Ribera, Josep‐Marǐa; Oriol, Albert; Spina, Michele; Tirelli, Umberto; Boué, François; Wilson, Wyndham H.; Wyen, Christoph; Dunleavy, Kieron; Noy, Ariela; Sparano, Joseph A.

doi:10.3324/haematol.2014.111112

Cited by 50 publications

(45 citation statements)

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“…Despite an initial good response, the patient did not tolerate the treatment of the recurrent disease. The lower CD4 count during the treatment of the recurrent disease supports the current recommendation that the caveat underlying the efficacy and safety of rituximab is the CD4 count [27,[36][37][38].…”

Section: • Dual Expression But Not Dual Rearrangements Of Myc and Bcl2supporting

confidence: 61%

“…The use of rituximab in HIV-infected patients with NHLs has been debated, because of the associated increased risk of infectious deaths, a consequence of rituximab-induced B-cell depletion on a background of severe T-cell depletion [27,36]. Recent studies have highlighted the safety and efficacy of chemotherapy in combination with rituximab in patients with CD4 counts above 50 cells/µL [27,36,37]. The index patient had chemotherapy and rituximab following initial diagnosis and recurrence.…”

Section: • Dual Expression But Not Dual Rearrangements Of Myc and Bcl2mentioning

confidence: 99%

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AIDS-Associated Pediatric High Grade B-cell Lymphoma with MYC and BCL2 Translocations

Mz¹,

Ramdial²,

Jb³

et al. 2017

J AIDS Clin Res

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Abstract"Double hit" lymphomas (DHLs) are now included as a distinct entity in the 2016 revised World Health Classification of lymphoid neoplasms under the rubric "High-grade B-cell lymphoma (HGBCL), with MYC and BCL2 and/or BCL6 translocations". While DHL/HGBCL with MYC and BCL2 translocations accounts for approximately 10% of all lymphomas with the phenotypic and immunophenotypic features of diffuse large B-cell lymphoma (DLBCL), to date, the entity is unreported in children <12 years and in patients with AIDS. In reporting a DHL/HGBCL with MYC and BCL2 translocations in a 10 year old boy, we contextualize, for the first time, its occurrence and clinicopathological profile in the context of pediatric HIV infection and AIDS. In so doing, the defining features of DHL/ HGBCL with MYC and BCL2 translocations in the updated 2016 WHO classification are discussed. In addition, the clinicopathological features and therapeutic approaches in children and adults and related challenges thereof, are highlighted. Finally, the spectrum of AIDS-associated lymphomas in children and adults are tabulated and the associated diagnostic and therapeutic challenges are addressed briefly.Citation: Msimang MZ, Ramdial PK, Kuppusamy JB, Nargan K, Sheik-Gafoor MH (2017) anterior colonic resection with colo-anal anastomosis and covering ileostomy was successfully undertaken, but the patient developed sepsis and required a relaparotomy for resection of necrotic colonic tissue. On recovery he received radiotherapy and further chemotherapy, but responded poorly and demised from multi-organ failure. Pathological featuresGross features: The lower anterior resection specimen measured 38 × 8 cm ( Figure 1A) and contained a 14 × 9 × 7 cm exophytic, creamwhite, fleshy tumor ( Figure 1B) with hemorrhagic foci, 12 cm and 3 cm from the proximal and distal excision margins, respectively. The proximal and circumferential resection margins were tumor-free. The microscopic findings confirmed an ulcerative, invasive malignancy with transmural involvement and a diffusely infiltrative pattern ( Figure 1C). The pleomorphic tumor cells were large with scant eosinophilic cytoplasm, indistinct cell borders and large, vesicular nuclei with distinctive nuclear membranes and prominent nucleoli ( Figure 1D). Brisk mitotic activity was evident. Immunohistochemically, there was bright and diffuse CD45 (Figure 2A), CD20 ( Figure 2B), BCL2 ( Figure 2C), BCL6 ( Figure 2D) and CD10 ( Figure 2E) immunopositivity. In addition, there was patchy MUM-1 ( Figure 3A) and approximately 60%, variable nuclear and cytoplasmic C-MYC immunopositivity ( Figure 3B) and a Ki-67 proliferation index of >90% ( Figure 3C). T-lymphocyte and terminal deoxynucleotidyl transferase immunomarkers were negative. Epstein Barr virus (EBV)-encoded small RNA (EBER) positivity ( Figure 3D) was confirmed on chromogen in-situ hybridization investigation.

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Section: • Dual Expression But Not Dual Rearrangements Of Myc and Bcl2supporting

confidence: 61%

Section: • Dual Expression But Not Dual Rearrangements Of Myc and Bcl2mentioning

confidence: 99%

AIDS-Associated Pediatric High Grade B-cell Lymphoma with MYC and BCL2 Translocations

Mz¹,

Ramdial²,

Jb³

et al. 2017

J AIDS Clin Res

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“…Various prognostic parameters have been used for predicting the treatment outcome of NHL [7, 11, 24]. Among them, the IPI is probably the most commonly used one [25].…”

Section: Discussionmentioning

confidence: 99%

“…Among them, the IPI is probably the most commonly used one [25]. Based on IPI, various systems such as FLIPI were designed for some special subtypes of lymphoma [24]. In this study, we have examined the efficacy of IPI parameters in HIV associated NHL (mostly BL and DLBCL).…”

Section: Discussionmentioning

confidence: 99%

Clinical and prognostic analysis of 78 patients with human immuno-deficiency virus associated non-Hodgkin’s lymphoma in Chinese population

Shen

Zhang

Liu

et al. 2017

Infect Agents Cancer

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BackgroundHuman Immuno-deficiency Virus (HIV) associated non-Hodgkin’s lymphoma (NHL) was a special group of disease, which manifests distinct clinical features and prognosis as compared with NHLs in patients without HIV. We performed this study to describe the clinical features of the disease and investigated the potential prognostic factors.MethodsHIV-infected patients who were newly diagnosed with NHL were enrolled in this study. The selection of anti-lymphoma treatment regimen was mainly dependent on the pathological subtypes of NHLs. Tumor response was reviewed and classified according to the International Workshop Criteria.ResultsA total of 78 patients were enrolled, among whom, 42 (53.8%) were with Diffuse large B cell Lymphoma (DLBCL), and 29 (37.2%) were with Burkitt lymphoma (BL). BL patients presented with higher risk features as compared with DLBCL in terms of numbers of extranodal diseases (P = 0.004) and poor Eastern cooperative oncology group (ECOG) score (P = 0.038). The estimated 2-year overall survival (OS) and progression free survival (PFS) rate was 74.3 ± 8.1%, 28.9 ± 11.0%, and 54.2 ± 8.1%, 19.2 ± 7.5% for DLBCL and BL, respectively. In multivariate analysis, international prognostic index (IPI) score was an independent prognostic factor for predicting both OS (OR = 2.172, 95% CI 1.579–2.987, P < 0.001) and PFS (OR = 1.838, 95% CI 1.406–2.402, P < 0.001).ConclusionsHIV associated NHLs represents a group of heterogeneous aggressive diseases with poor prognosis. IPI parameters were still effective in predicting the prognosis of HIV associated NHLs.Electronic supplementary materialThe online version of this article (doi:10.1186/s13027-017-0120-2) contains supplementary material, which is available to authorized users.

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“…Recent reports [9,10] have shown that other scores such as the HIV-score, the age-adjusted International Prognostic Index for non-Hodgkin Lymphoma and in a more comprehensive way, the AIDS-related lymphoma International Prognostic Index correlate with prognosis in HIV-infected patients with lymphoma treated with frontline rituximab-containing chemoimmunotherapy. However, in our experience, in the context of salvage therapy, these prognostic scores fail to identify the proportion of patients with a better prognosis, whereas only the evaluation of disease chemosensitivity and co-morbidities weight has a role.…”

mentioning

confidence: 99%

Autologous stem cell transplantation in HIV-positive patients affected by relapsed/partially responding lymphoma: let it be

Zanet

Michieli

Tirelli

2016

Expert Review of Hematology

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A new prognostic score for AIDS-related lymphomas in the rituximab-era

Cited by 50 publications

References 31 publications

AIDS-Associated Pediatric High Grade B-cell Lymphoma with MYC and BCL2 Translocations

AIDS-Associated Pediatric High Grade B-cell Lymphoma with MYC and BCL2 Translocations

Clinical and prognostic analysis of 78 patients with human immuno-deficiency virus associated non-Hodgkin’s lymphoma in Chinese population

Autologous stem cell transplantation in HIV-positive patients affected by relapsed/partially responding lymphoma: let it be

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