LymphedemaV1, Main, Exploration, bibRecord, 002A13

IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS)-ASSOCIATED BURKITT LYMPHOMA FOLLOWING COMBINATION ANTI-RETROVIRAL THERAPY IN HIV-INFECTED PATIENTS

Identifieur interne : 002A13 ( Main/Exploration ); précédent : 002A12; suivant : 002A14

IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS)-ASSOCIATED BURKITT LYMPHOMA FOLLOWING COMBINATION ANTI-RETROVIRAL THERAPY IN HIV-INFECTED PATIENTS

Auteurs : Prakash Vishnu [États-Unis] ; Russell P. Dorer [États-Unis] ; David M. Aboulafia [États-Unis]

Source :

Clinical lymphoma, myeloma & leukemia [ 2152-2650 ] ; 2014.

RBID : PMC:4607473

Abstract

HIV/AIDS-associated immune reconstitution inflammatory syndrome (IRIS) is defined as a paradoxical worsening or unmasking of infections and autoimmune diseases, following initiation of combination anti-retroviral therapy (cART). More recently, the case definition of IRIS has been broadened to include certain malignancies including Kaposi’s sarcoma, and less frequently Hodgkin’s and non-Hodgkin’s lymphoma (NHL). Here in we describe 3 patients infected with HIV who began cART and within a median of 15 weeks each achieved non-detectable HIV viral loads, and yet within 6 months presented for medical attention with fevers, night sweats, weight loss and bulky lymphadenopathy. Laboratory studies included elevated lactate dehydrogenase and β-2 microglobulin levels and well preserved CD4⁺ lymphocyte counts in excess of 350 cells/µL. In each patient lymph node biopsies were diagnostic of Burkitt lymphoma (BL). Patients were managed with multi-agent chemotherapy in conjunction with cART. We also survey the medical literature of other cases of IRIS-associated BL. Although the pathogenesis of IRIS-associated BL is not well elucidated, chronic antigenic stimulation coupled with immune deterioration, followed by subsequent restoration of the immune response and aberrant cytokine expression may be a pathway to lymphomagenesis. IRIS-associated BL should be suspected in patients with normal or near normal CD4⁺ lymphocyte counts who develop progressive lymphadenopathy post-initiation of cART.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607473

DOI: 10.1016/j.clml.2014.09.009
PubMed: 25458079
PubMed Central: 4607473

Affiliations:

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<front><div type="abstract" xml:lang="en"><p id="P1">HIV/AIDS-associated immune reconstitution inflammatory syndrome (IRIS) is defined as a paradoxical worsening or unmasking of infections and autoimmune diseases, following initiation of combination anti-retroviral therapy (cART). More recently, the case definition of IRIS has been broadened to include certain malignancies including Kaposi’s sarcoma, and less frequently Hodgkin’s and non-Hodgkin’s lymphoma (NHL). Here in we describe 3 patients infected with HIV who began cART and within a median of 15 weeks each achieved non-detectable HIV viral loads, and yet within 6 months presented for medical attention with fevers, night sweats, weight loss and bulky lymphadenopathy. Laboratory studies included elevated lactate dehydrogenase and β-2 microglobulin levels and well preserved CD4<sup>+</sup>
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IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS)-ASSOCIATED BURKITT LYMPHOMA FOLLOWING COMBINATION ANTI-RETROVIRAL THERAPY IN HIV-INFECTED PATIENTS

IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS)-ASSOCIATED BURKITT LYMPHOMA FOLLOWING COMBINATION ANTI-RETROVIRAL THERAPY IN HIV-INFECTED PATIENTS

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