Journal of Clinical Oncology, Vol 21, Issue 21
(November), 2003: 3948-3954
© 2003 American Society for Clinical Oncology
Clinical Features and Outcome of Primary Effusion Lymphoma in HIV-Infected Patients: A Single-Institution Study
Cecilia Simonelli,
Michele Spina,
Roberta Cinelli,
Renato Talamini,
Rosamaria Tedeschi,
Annunziata Gloghini,
Emanuela Vaccher,
Antonino Carbone,
Umberto Tirelli
From the Divisions of Medical Oncology A and Pathology, and Epidemiology and Microbiology Units, National Cancer Institute, Aviano, Italy.
Address reprint requests to Umberto Tirelli, MD, Division of Medical Oncology A, National Cancer Institute, Via Pedemontana Occidentale 12, 33081 Aviano (PN), Italy; e-mail: omaoffice{at}cro.it.
Purpose: To describe the clinical features and outcome of HIV-associated primary effusion lymphoma (PEL) and to compare them with those of the other HIV-associated non-Hodgkin’s lymphomas (NHLs).
Patients and Methods: From April 1987 to June 2002, 277 patients with HIV infection and systemic NHL were diagnosed and treated in our institution. Clinical features and outcome of PEL patients were compared with the features and outcomes of 162 patients belonging to the following histologic subtypes: plasmoblastic lymphoma of oral cavity (PBLOC, n = 11), immunoblastic lymphoma (IBL, n = 76), and centroblastic B-cell lymphoma (CBCL, n = 75).
Results: Among the 277 NHL patients, PEL was diagnosed in 11 patients (4%). Eight of 11 patients were treated with a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)–like regimen. Complete remission was reached in 42% of patients, with a median survival time of 6 months. When the clinical features and outcome of 11 PEL patients were compared with the other three groups of patients affected by NHL, at the onset of the disease, no statistically significant differences were observed in demographic data, CD4 absolute number, HIV viremia plasma levels, and clinical characteristics. When we compared the outcome of PEL patients with the CBCL group, a statistically significant worse outcome was observed; however, the clinical outcome of PEL patients was not significantly different from the outcome observed in the other two groups (PBLOC and IBL groups).
Conclusion: PEL is a rare HIV-associated NHL type occurring as a late manifestation of HIV infection with a poor clinical outcome and a shorter overall survival compared with CBCL patients.
Supported by grants from the Associazione Italiana per la Ricerca sul Cancro and Istituto Superiore Di Sanita.
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