A non-chemotherapy treatment of a primary effusion lymphoma: durable remission after intracavitary cidofovir in HIV negative PEL refractory to chemotherapy

Human Herpesvirus 8–Related Primary Effusion Lymphoma After Liver Transplantation

“…Treatment directed at the HHV8 virus such as cidofovir, either systemic or injected directly into the cavity, has been used to target HHV8, with good efficacy noted in some case reports (4,6,7). In the present case, the patient initially had one body cavity involved with PT-PEL and intrapleural cidofovir was administered in that setting.…”

“…Intrapleural cidofovir 3 mg/kg was trialed based on previously published reports using this approach in nontransplant-related primary effusion lymphoma (PEL) patients (6,7). While the initial treatment plan was for weekly cidofovir installations, he developed acute renal failure following the first dose.…”

Primary Effusion Lymphoma

“…These include the addition of antiviral therapy as well as inhibition of specific cellular targets. Two recent reports have described treating four elderly patients with intrapleural injections of the antiviral drug cidofovir with durations of remissions lasting several months [62,63]. The efficacy of antiviral treatment can potentially be improved if PEL cells can be induced to enter the lytic phase of viral replication, as the majority of antiviral drugs are most effective in the lytic phase.…”

Primary Effusion Lymphoma Diagnosed by Pericardiocentesis

“…There have been two case reports of autologous stem cell transplant for PEL but not enough data to recommend this treatment (21,22). In other case reports, the effusions were treated with directly injected cidofovir, which was associated with a several-month remission in one patient (23,24). Two potential experimental therapies are bortezomib, a proteasome inhibitor, and drugs such as LY294002, which inhibit the phosphatidylinositol 3′-kinase/AKT pathway.…”