Non-AIDS-defining hematological malignancies in HIV-infected patients

Hagiwara, Shotaro; Yotsumoto, Mihoko; Odawara, Takashi; Ajisawa, Atsushi; Uehira, Tomoko; Nagai, Hirokazu; Tanuma, Junko; Okada, Seiji

doi:10.1097/qad.0b013e32835a5a7a

Cited by 16 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, an association between the incidence of non-AIDS-defining cancers and ART remains controversial. An increase of non-AIDS-defining cancers in patients receiving ART was shown in previous clinical reports [26,27], but a separate study showed that, with the exception of long-term protease inhibitor usage, ART exposure was generally not associated with a risk of non-AIDS-defining cancers [28]. The reasons for increased risk of non-AIDS-defining cancers in patients on ART are unclear, but might reflect the concomitant increase of the mean age at autopsy during the study period.…”

Section: Discussionsupporting

confidence: 55%

The prevalence of opportunistic infections and malignancies in autopsied patients with human immunodeficiency virus infection in Japan

et al. 2014

Self Cite

View full text Add to dashboard Cite

BackgroundOpportunistic infections and malignancies such as malignant lymphoma and Kaposi sarcoma are significant complications of human immunodeficiency virus (HIV) infection. However, following the introduction of antiretroviral therapy in Japan in 1997, the incidence of clinical complications has decreased. In the present study, autopsy cases of HIV infection in Japan were retrospectively investigated to reveal the prevalence of opportunistic infections and malignancies.MethodsA total of 225 autopsy cases of HIV infection identified at 4 Japanese hospitals from 1985–2012 were retrospectively reviewed. Clinical data were collected from patient medical records.ResultsMean CD4 counts of patients were 77.0 cells/μL in patients who received any antiretroviral therapy during their lives (ART (+) patients) and 39.6 cells/μL in naïve patients (ART (−) patients). Cytomegalovirus infection (142 cases, 63.1%) and pneumocystis pneumonia (66 cases, 29.3%) were the most frequent opportunistic infections, and their prevalence was significantly lower in ART (+) patients than ART (−) patients. Non-Hodgkin lymphoma and Kaposi sarcoma were observed in 30.1% and 16.2% of ART (−) patients, and 37.9% and 15.2% of ART (+) patients, respectively. Malignant lymphoma was the most frequent cause of death, followed by cytomegalovirus infection regardless of ART. Non-acquired immunodeficiency syndrome (AIDS)-defining cancers such as liver and lung cancer caused death more frequently in ART (+) patients (9.1%) than in ART (−) patients (1.5%; P = 0.026).ConclusionsThe prevalence of infectious diseases and malignancies were revealed in autopsy cases of HIV infection in Japan. The prevalence of cytomegalovirus infection and pneumocystis pneumonia at autopsy were lower in ART (+) patients than ART (−) patients. Higher prevalence of non-AIDS defining malignancies among ART (+) patients than ART (−) patients suggests that onsets of various opportunistic infections and malignancies should be carefully monitored regardless of whether the patient is receiving ART.

show abstract

Section: Discussionsupporting

confidence: 55%

The prevalence of opportunistic infections and malignancies in autopsied patients with human immunodeficiency virus infection in Japan

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

“…In brief, a 2.5-fold increase in leukemia frequency has been documented in HIV-infected individuals from the United States [34], while a two-fold increase in AML incidence has been calculated in a French study, compared with the general population [35]. Consistent with this, the estimated incidence of AML in Japanese HIV-positive people was 8/100,000 persons per year, between 1991 and 2009 [36]. A more recent retrospective national multicenter study from France revealed that acute leukemia incidence in PLWH was not significantly different than in general population, but acute leukemia occurred earlier (mean age 50 years for AML patients), compared with HIV-negative counterparts [37].…”

Section: Which Is the Actual Epidemiology Of Aml In Plwh?mentioning

confidence: 79%

“…According to these data, a careful patient stratification based on CD4+ cell counts and karyotype may be suggested, considering induction chemotherapy a reasonable option mainly for HIV-associated AML with CD4+ cells > 200/µL and without unfavorable karyotype [32]. Overall, AML in PLWH has exhibited dismal clinical outcomes, with poorer OS compared with HIV-negative counterparts, despite generally younger age at presentation (Tables 1 and 2) [32,[36][37][38][39]48,53,54]. Scanty information about either cytogenetic or molecular abnormalities is available for cases of AML in PLWH, thereby avoiding the possibility to draw any firm conclusion on their frequencies and prognostic impact ( Table 2) [32,36,37,39,48,54].…”

Section: Should Aml In Hiv-positive Subjects Be Managed Differently Fmentioning

confidence: 99%

“…Overall, AML in PLWH has exhibited dismal clinical outcomes, with poorer OS compared with HIV-negative counterparts, despite generally younger age at presentation (Tables 1 and 2) [32,[36][37][38][39]48,53,54]. Scanty information about either cytogenetic or molecular abnormalities is available for cases of AML in PLWH, thereby avoiding the possibility to draw any firm conclusion on their frequencies and prognostic impact ( Table 2) [32,36,37,39,48,54]. However, AML could potentially parallel the features of MDS in the setting of HIV-positive patients, which are mainly characterized by high prevalence of complex karyotypes and chromosome 7 abnormalities, resulting in higher risk and faster progression to leukemia, compared to MDS in HIV-uninfected subjects [23,55,56].…”

Section: Should Aml In Hiv-positive Subjects Be Managed Differently Fmentioning

confidence: 99%

See 1 more Smart Citation

Acute Myeloid Leukemia in Patients Living with HIV Infection: Several Questions, Fewer Answers

Forghieri

Nasillo

Bettelli

et al. 2020

IJMS

View full text Add to dashboard Cite

Both human immunodeficiency virus (HIV) infection and acute myeloid leukemia (AML) may be considered relatively uncommon disorders in the general population, but the precise incidence of AML in people living with HIV infection (PLWH) is uncertain. However, life expectancy of newly infected HIV-positive patients receiving anti-retroviral therapy (ART) is gradually increasing, rivaling that of age-matched HIV-negative individuals, so that the occurrence of AML is also expected to progressively increase. Even if HIV is not reported to be directly mutagenic, several indirect leukemogenic mechanisms, mainly based on bone marrow microenvironment disruption, have been proposed. Despite a well-controlled HIV infection under ART should no longer be considered per se a contraindication to intensive chemotherapeutic approaches, including allogeneic hematopoietic stem cell transplantation, in selected fit patients with AML, survival outcomes are still generally unsatisfactory. We discussed several controversial issues about pathogenesis and clinical management of AML in PLWH, but few evidence-based answers may currently be provided, due to the limited number of cases reported in the literature, mainly as case reports or small retrospective case series. Prospective multicenter clinical trials are warranted to more precisely investigate epidemiology and cytogenetic/molecular features of AML in PLWH, but also to standardize and further improve its therapeutic management.

show abstract

“…In our previous retrospective nationwide study in Japan between 1991 and 2010 from 511 institutions among all regional centers and all educational hospitals certified by the Japanese Society of Hematology (4,14), there were only 19 HIV positive HL patients. Among them, we found 16 evaluable EBV + HIV positive HL patients for analysis in this study.…”

Section: Methodsmentioning

confidence: 99%

HIV positivity may not have a negative impact on survival in Epstein‑Barr virus‑positive Hodgkin lymphoma: A Japanese nationwide retrospective survey

et al. 2018

Self Cite

View full text Add to dashboard Cite

There has been no comparative clinical study focused on differences in the clinical features of Epstein-Barr virus (EBV) Hodgkin lymphoma (HL) between HIV-positive and -negative cases. In a nationwide survey from 511 institutions in Japan, the present study investigated 16 EBV+ HIV HL patients. To further clarify their characteristics in comparison with EBV+ HIV HL (n=34) in the combination antiretroviral therapy era in Japan, the present study was performed. Results indicated that EBV HIV HL frequently occurred in a younger population compared with EBV HIV HL (P=0.0295), and that the EBV HIV HL group was not associated with the nodular sclerosis subtype in the population who were below the age of 40. Notably, the EBV HIV HL group had a significantly higher frequency of extra-nodal involvement (P=0.0214), including marrow invasion. In the advanced stage, 80% of those with EBV HIV HL did not require dose-reduction and in the majority of cases, chemotherapy was completed. There were no significant differences in the complete remission rate (P=0.1961), overall survival (P=0.200) and progression-free survival (P=0.245) between EBV HIV HL (median observational period, 23.5 months) and EBV HIV HL (median observational period, 64.5 months), suggesting that HIV positivity may not have a negative impact on the clinical outcome of EBV HL. Notably, standard chemotherapy is effective and tolerable for EBV HL, regardless of HIV infection.

show abstract

Non-AIDS-defining hematological malignancies in HIV-infected patients

Cited by 16 publications

References 19 publications

The prevalence of opportunistic infections and malignancies in autopsied patients with human immunodeficiency virus infection in Japan

The prevalence of opportunistic infections and malignancies in autopsied patients with human immunodeficiency virus infection in Japan

Acute Myeloid Leukemia in Patients Living with HIV Infection: Several Questions, Fewer Answers

HIV positivity may not have a negative impact on survival in Epstein‑Barr virus‑positive Hodgkin lymphoma: A Japanese nationwide retrospective survey

Contact Info

Product

Resources

About