Hodgkin Lymphoma in People Living with HIV
Por:
Navarro, JT, Molto, J, Tapia, G and Ribera, JM
Publicada:
1 sep 2021
Ahead of Print:
29 ago 2021
Resumen:
Simple Summary Hodgkin lymphoma (HL) is a non-AIDS defining neoplasm, but people living with HIV (PLWH) have between a 5- and 26-fold higher risk of developing it than the general population. Epstein-Barr virus is present in almost all HIV-related HL cases, and plays an important role in its etiopathogenesis. Despite the aggressive characteristics, the prognosis of HL affecting PLWH is similar to that of the general population if patients are treated following the same recommendations. Administration of cART concomitantly with chemotherapy is highly recommended. However, this combination may be challenging due to drug-drug interactions and overlapping toxicity. Thus, interdisciplinary collaboration between hemato-oncologists and HIV specialists is crucial for the optimal treatment of both lymphoma and HIV infection. Despite widespread use of combined antiretroviral therapy (cART) and increased life expectancy in people living with HIV (PLWH), HIV-related lymphomas (HRL) remain a leading cause of cancer morbidity and mortality for PLWH, even in patients optimally treated with cART. While the incidence of aggressive forms of non-Hodgkin lymphoma decreased after the advent of cART, incidence of Hodgkin lymphoma (HL) has increased among PLWH in recent decades. The coinfection of Epstein-Barr virus plays a crucial role in the pathogenesis of HL in the HIV setting. Currently, PLWH with HRL, including HL, are treated similarly to HIV-negative patients and, importantly, the prognosis of HL in PLWH is approaching that of the general population. In this regard, effective cART during chemotherapy is strongly recommended since it has been shown to improve survival rates in all lymphoma subtypes, including HL. As a consequence, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential drug-drug interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PLWH with HL. In this article the authors review and update the epidemiological, clinical and biological aspects of HL presenting in PLWH with special emphasis on advances in prognosis and the factors that have contributed to it.
Filiaciones:
:
Inst Catala Oncol Germans Trias & Pujol Hosp, Dept Hematol, Carretera Canyet S-N, Barcelona 08916, Spain
Josep Carreras Leukaemia Res Inst, Badalona 08916, Spain
Univ Autonoma Barcelona, Dept Med, Unitat Docent Germans Trias & Pujol, Can Ruti Campus, Badalona 08916, Spain
:
Univ Autonoma Barcelona, Dept Med, Unitat Docent Germans Trias & Pujol, Can Ruti Campus, Badalona 08916, Spain
Germans Trias & Pujol Hosp, Fundacio Lluita Sida, Dept Infect Dis, Badalona 08916, Spain
:
Univ Autonoma Barcelona, Dept Med, Unitat Docent Germans Trias & Pujol, Can Ruti Campus, Badalona 08916, Spain
Germans Trias & Pujol Hosp, Dept Pathol, Badalona 08916, Spain
:
Inst Catala Oncol Germans Trias & Pujol Hosp, Dept Hematol, Carretera Canyet S-N, Barcelona 08916, Spain
Josep Carreras Leukaemia Res Inst, Badalona 08916, Spain
Univ Autonoma Barcelona, Dept Med, Unitat Docent Germans Trias & Pujol, Can Ruti Campus, Badalona 08916, Spain
Green Published, gold
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