Risk Factors for Febrile Neutropenia during Chemotherapy for HIV-Related Lymphoma

We evaluated risk factors for neutropenic fever and febrile prolonged neutropenia during vincristine-including chemotherapy to treat HIV-related lymphoma to investigate whether protease inhibitor (PI) treatment is associated with infectious complications due to drug interactions with chemotherapeutic agents. We included all HIV patients who received chemotherapy including vincristine for lymphoma at a single referral center in 1999-2010. Neutropenic fever was defined as absolute neutrophil count < 500 cells/microL with body temperature over 38degrees C; and prolonged neutropenia was defined if it persisted over 7 days. CODOX-M/IVAC and Stanford regimens were considered high-risk regimens for prolonged neutropenia. We analyzed 48 cycles of chemotherapy in 17 HIV patients with lymphoma. There were 22 neutropenic fever and 12 febrile prolonged neutropenia events. In multivariate analysis, neutropenic fever was associated with old age and low CD4 cell count, but not with PI use or ritonavir-boosted PI use. Low CD4 cell count and high-risk regimens were associated with febrile prolonged neutropenia. Neutropenic fever and febrile prolonged neutropenia is associated with old age, low CD4 cell count, and high-risk regimens, but not PI use, in HIV patients undergoing chemotherapy including vincristine for lymphoma.

Coexistencia de linfoma plasmablástico, sarcoma de Kaposi y enfermedad de Castleman en un paciente con infección por virus de inmunodeficiencia humana / Coexistence of plasmablastic lymphoma, Kaposi sarcoma and Castleman disease in a patient with HIV infection

El linfoma plasmablástico (LP) es un linfoma de células B poco común que está fuertemente asociado con la infección por el virus de inmunodeficiencia humana (VIH), y muestra una afinidad característica de presentación extra-ganglionar en la cavidad oral. Informamos el caso de un LP afectando el estómago en un paciente masculino de 36 años de edad con infección por VIH, asociado con sarcoma de Kaposi (SK) en áreas adyacentes al linfoma. Tenía el antecedente de enfermedad de Castleman y SK en una biopsia de ganglio linfático.

Plasmablastic lymphoma (PL) is an uncommon B-cell lymphoma that is strongly associated with human immunodeficiency virus (HIV) infection, and displays distinctive affinity for extranodal presentation in the oral cavity. We report the case of a PL involving the stomach in a 36 year-old man HIV+ patient, associated with Kaposi sarcoma (KS) in sections adjacent to lymphoma. He had a positive history of Castleman disease and KS in a lymphoid node biopsy.

Fine-needle aspiration cytology findings in human immunodeficiency virus lymphadenopathy.

Thirty-six human immunodeficiency virus (HIV)-positive patients with lymphadenopathy were subjected to fine-needle aspiration cytology (FNAC) over a period of 2 years. The maximum number of cases was reported in the age group of 21 to 30 years. Majority of the patients were males. The maximum number of cases had tuberculosis (58.3%) followed by reactive lymphadenitis (36.1%), non-Hodgkin's lymphoma (2.7%) and acute suppurative lymphadenitis (2.7%). FNAC is an important diagnostic tool in the evaluation of lymphadenopathy in HIV-positive patients.

Invaginación ileocecal como forma de presentación de linfoma no Hodgkin en un paciente con SIDA / Ileocolic intussusception due to a large B cell lymphoma in a patient with AIDS

La invaginación intestinal es poco frecuente en el adulto. Aquí se describe el caso de un paciente adulto con SIDA que desarrolló una invaginación ileocólica secundaria a un linfoma de células B localizado en el ciego. Los hallazgos quirúrgicos fueron: íleon libre de tumor, invaginado en el ciego infiltrado por la neoplasia. Se realizó la resección del hemicolon derecho debido a la tumoración localizada en el ciego, causante de la invaginación. Se revisó la literatura inglesa y española sobre este tema.

Adult intussusception is rare. Here, we describe a case of an AIDS adult patient who developed an ileocolic intussusception secondary to a large B cell lymphoma of the cecum. Surgical findings included the ileon free of the tumor and invaginated within the cecum with infiltrating neoplasm. Surgical treatment included the resection of the right hemicolon because of the tumor, located in the cecum, causing intussusception. The english and spanish literature is reviewed.

Fatal secondary pulmonary hypertension due to cardiac involvement in AIDS-associated Burkitt's lymphoma.

Primary cardiac lymphomas are rare lesions in children with acquired immunodeficiency syndrome (AIDS). Most of them are high-grade Burkitt's or Burkitt-like lymphomas. They usually present with congestive cardiac failure, pericardial effusion or tamponade, arrhythmias, with predominant systemic 'B' symptoms and often with widespread extranodal involvement. The clinical profile and operative and pathological findings of a 4-year-old boy with AIDS-associated Burkitt's lymphoma of the heart presenting with acute right heart failure and fatal secondary pulmonary hypertension is reported.

Primary pulmonary AIDS-related lymphoma

El compromiso extranodal es frecuente en los linfomas asociados con la enfermedad debida al virus de la inmunodeficiencia humana y su consecuencia, el síndrome de inmunodeficiencia adquirida. Sin embargo, el linfoma pulmonar primario es muy raro y solo existen pocos casos publicados en la literatura. La presentación clínica de esta complicación es inespecífica, con síntomas "B" y manifestaciones respiratorias. Generalmente, la radiografía de tórax muestra nódulos periféricos o masas que pueden cavitarse y los pacientes presentan inmunodeficiencia severa al momento del diagnóstico. El linfoma pulmonar primario asociado con el sida es un tumor de alto grado, de células B y asociado en su patogenia con el virus de Epstein-Barr. Se relata un caso de linfoma primario de pulmón que se presentó bajo la forma radiológica de una atelectasia global del pulmón izquierdo.

Linfoma leptomeníngeo en un niño con infección por el virus de la inmunodeficiencia humana / Leptomeningeal lymphoma in a child infected with the human immunodeficiency virus

El linfoma primario del sistema nervioso central en pacientes pediátricos VIH positivos es poco frecuente. Se presenta un paciente, de siete años de edad, de sexo masculino, con síndrome de inmunodeficiencia adquirida, que desarrolló un linfoma decélulas B con localización leptomeníngea. El niño inició el cuadro con síntomas de alteración del sensorio, hipertensión endocraneana y amaurosis bilateral. El diagnóstico se efectuó por biopsia cerebral, inmunofenotipo de las células B del líquido cefalorraquídeo, además de PCR positiva para virus de Epstein Barr en el líquido. Realizó tratamiento con quimioterapia intratecal y sistémica. Mejoraron los síntomas durante quince meses y luego recidivó en la región talámica. Cumplió radioterapia craneo espinal y falleció cuatro meses después de la recidiva. En este artículo se realiza una revisión de la bibliografía sobre esta enfermedad, señalando el carácter excepcional de este paciente por tratarse de un linfoma localizado en forma exclusiva en el sistema nervioso central y, más precisamente, en la leptomeninges

Associação de CD23 sérico sCD23 e linfoma não Hodgkin em pacientes com AIDS / Association of CD23 serum (sCD23) and non Hodgkin's lymphoma in patients with AIDS

Há evidências de que níveis elevados de sCD23 poderiam ser um marcador sorológico para linfoma não-Hodgkin (LNH) em pacientes com infecção pelo HIV. Realizamos um estudo transversal para medir os níveis séricos de sCD23 em 5 grupos de pacientes: LNH HIV positivos, pacientes com LNH HIV negativos, com AIDS sem LNH, e doadores de sangue HIV positivos e negativos. O nível sérico médio de sCD23 foi .de 7,178,42 g/L nos patients com AIDS e LNH, 4,18 4,99g/L nos patients com AIDS sem LNH, 7,322,09 g/L nos doadores de sangue HIV positivo, 4,701,75 g/L nos doadores de sangue HIV negativo e 15,0220,96 nos pacientes com LNH HIV negativos (P=0,001) / There are evidences that elevated serum levels of sCD23 could be used as a marker to non-Hodgkin’s Lymphoma (NHL) in patients with HIV infection. In order to verify this hipotheses, we carried out a transversal study to measure levels of sCD23 in 5 groups of patients: HIV positive with NHL, HIV negative with NHL, AIDS without NHL, and HIV positive and negative blood donors. The mean levels of sCD23 were 7.178.42g/L in AIDS with NHL, 4.18 4.99g/L in AIDS without NHL, 7.322.09 g/L in the HIV positive blood donors, 4.701.75 g/L in the HIV negative blood donors, and 15.0220.96 in the HIV negative patients with NHL (P=0.001)...

AIDS related malignant disease at regional institute of medical sciences.

26 AIDS patients within a period of 3 years were studied for associated malignant disease. There were 4 associated malignancy. The commonest AIDS associated malignant disease found is Kaposi's sarcoma seen in 2 patients. In one each of the AIDS patients, association of Non-Hodgkin's lymphoma and acute Promyelocytic leukemia (M3) was found. Findings by other workers are reviewed. With new trends in management of AIDS patients that prolong their survival, an increase in the incidence of AIDS associated malignancy is anticipated.