AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy

In economically developed countries, AIDS-related lymphoma (ARL) accounts for a large proportion of malignances in HIV-infected individuals. Since the introduction of highly active anti-retroviral therapy (HAART) in 1996, epidemiology and prognosis of ARL have changed. While there is a slight increa...

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Main Authors: Prakash Vishnu, David M. Aboulafia
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Advances in Hematology
Online Access:http://dx.doi.org/10.1155/2012/485943
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author Prakash Vishnu
David M. Aboulafia
author_facet Prakash Vishnu
David M. Aboulafia
author_sort Prakash Vishnu
collection DOAJ
description In economically developed countries, AIDS-related lymphoma (ARL) accounts for a large proportion of malignances in HIV-infected individuals. Since the introduction of highly active anti-retroviral therapy (HAART) in 1996, epidemiology and prognosis of ARL have changed. While there is a slight increase in the incidence of Hodgkin’s lymphoma in HIV-infected individuals, use of HAART has contributed to a decline in the incidence of non-Hodgkin’s lymphoma (NHL) and also a decrease in the overall incidence of ARL. Strategies that employ HAART, improved supportive care, and the use of Rituximab with multi-agent chemotherapy have contributed to improved rates of complete remission and survival of patients with ARL that rival those seen in stage and histology matched HIV negative NHL patients. Most recent clinical trials demonstrate better outcomes with the use of rituximab in ARL. Tumor histogenesis (germinal center vs. non-germinal center origin) is associated with lymphoma-specific outcomes in the setting of AIDS-related diffuse-large B cell lymphoma. High-dose chemotherapy (HDCT) and autologous stem cell rescue (ASCT) can be effective for a subset of patients with relapsed ARL. HIV sero-status alone should not preclude consideration of ASCT in the setting of ARL relapse. Clinical trials investigating the role of allogeneic hematopoietic stem cell transplant in ARL are currently underway.
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spelling doaj-art-80423abeb42e4578979158b2cb708ac12025-02-03T05:47:27ZengWileyAdvances in Hematology1687-91041687-91122012-01-01201210.1155/2012/485943485943AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral TherapyPrakash Vishnu0David M. Aboulafia1Floyd & Delores Jones Cancer Institute, Virginia Mason Medical Center, Seattle, WA 98101, USAFloyd & Delores Jones Cancer Institute, Virginia Mason Medical Center, Seattle, WA 98101, USAIn economically developed countries, AIDS-related lymphoma (ARL) accounts for a large proportion of malignances in HIV-infected individuals. Since the introduction of highly active anti-retroviral therapy (HAART) in 1996, epidemiology and prognosis of ARL have changed. While there is a slight increase in the incidence of Hodgkin’s lymphoma in HIV-infected individuals, use of HAART has contributed to a decline in the incidence of non-Hodgkin’s lymphoma (NHL) and also a decrease in the overall incidence of ARL. Strategies that employ HAART, improved supportive care, and the use of Rituximab with multi-agent chemotherapy have contributed to improved rates of complete remission and survival of patients with ARL that rival those seen in stage and histology matched HIV negative NHL patients. Most recent clinical trials demonstrate better outcomes with the use of rituximab in ARL. Tumor histogenesis (germinal center vs. non-germinal center origin) is associated with lymphoma-specific outcomes in the setting of AIDS-related diffuse-large B cell lymphoma. High-dose chemotherapy (HDCT) and autologous stem cell rescue (ASCT) can be effective for a subset of patients with relapsed ARL. HIV sero-status alone should not preclude consideration of ASCT in the setting of ARL relapse. Clinical trials investigating the role of allogeneic hematopoietic stem cell transplant in ARL are currently underway.http://dx.doi.org/10.1155/2012/485943
spellingShingle Prakash Vishnu
David M. Aboulafia
AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy
Advances in Hematology
title AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy
title_full AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy
title_fullStr AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy
title_full_unstemmed AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy
title_short AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy
title_sort aids related non hodgkin s lymphoma in the era of highly active antiretroviral therapy
url http://dx.doi.org/10.1155/2012/485943
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