Abstract
Anaplastic large-cell lymphoma (ALCL) has rarely been described in patients with acquired immunodeficiency syndrome (AIDS). Reports of treatment of ALCL in the setting of AIDS are rare as well. Dose-adjusted EPOCH (DA-EPOCH; etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin) has been shown to be well tolerated and effective in the treatment of AIDS-related aggressive B-cell lymphomas. Treatment of AIDS-associated ALCL with DA-EPOCH has not been reported. This report describes two patients with AIDS-associated ALCL treated with DA-EPOCH chemotherapy. Both patients presented with advanced disease. Excellent clinical response was observed in both patients. The first patient completed six cycles of chemotherapy and remains in complete remission at 12 months of follow up. The second patient has received 2 cycles of chemotherapy thus far. She had an excellent response with rapid improvement of cutaneous disease and lymphadenopathy starting three days after the first cycle. Repeat imaging after two cycles of chemotherapy showed marked radiologic improvement as well. Chemotherapy was well tolerated by both patients. Our experience suggests that DA-EPOCH is an effective treatment for AIDS-associated ALCL.
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- Agnarsson B. A., Kadin M. E. Ki-1 positive large cell lymphoma. A morphologic and immunologic study of 19 cases. Am J Surg Pathol. 1988 Apr;12(4):264–274. doi: 10.1097/00000478-198804000-00002. [DOI] [PubMed] [Google Scholar]
- Bower Mark, Gazzard Brian, Mandalia Sundhiya, Newsom-Davis Tom, Thirlwell Christina, Dhillon Tony, Young Anne Marie, Powles Tom, Gaya Andrew, Nelson Mark. A prognostic index for systemic AIDS-related non-Hodgkin lymphoma treated in the era of highly active antiretroviral therapy. Ann Intern Med. 2005 Aug 16;143(4):265–273. doi: 10.7326/0003-4819-143-4-200508160-00007. [DOI] [PubMed] [Google Scholar]
- Chadburn A., Cesarman E., Jagirdar J., Subar M., Mir R. N., Knowles D. M. CD30 (Ki-1) positive anaplastic large cell lymphomas in individuals infected with the human immunodeficiency virus. Cancer. 1993 Nov 15;72(10):3078–3090. doi: 10.1002/1097-0142(19931115)72:10<3078::aid-cncr2820721033>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
- Gascoyne R. D., Aoun P., Wu D., Chhanabhai M., Skinnider B. F., Greiner T. C., Morris S. W., Connors J. M., Vose J. M., Viswanatha D. S. Prognostic significance of anaplastic lymphoma kinase (ALK) protein expression in adults with anaplastic large cell lymphoma. Blood. 1999 Jun 1;93(11):3913–3921. [PubMed] [Google Scholar]
- Herbst H., Anagnostopoulos J., Heinze B., Dürkop H., Hummel M., Stein H. ALK gene products in anaplastic large cell lymphomas and Hodgkin's disease. Blood. 1995 Sep 1;86(5):1694–1700. [PubMed] [Google Scholar]
- Little Richard F., Pittaluga Stefania, Grant Nicole, Steinberg Seth M., Kavlick Mark F., Mitsuya Hiroaki, Franchini Genoveffa, Gutierrez Martin, Raffeld Mark, Jaffe Elaine S. Highly effective treatment of acquired immunodeficiency syndrome-related lymphoma with dose-adjusted EPOCH: impact of antiretroviral therapy suspension and tumor biology. Blood. 2003 Feb 27;101(12):4653–4659. doi: 10.1182/blood-2002-11-3589. [DOI] [PubMed] [Google Scholar]
- Morton Lindsay M., Wang Sophia S., Devesa Susan S., Hartge Patricia, Weisenburger Dennis D., Linet Martha S. Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001. Blood. 2005 Sep 8;107(1):265–276. doi: 10.1182/blood-2005-06-2508. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Peng Yu-Long, Huang Hui-Qiang, Lin Xu-Bin, Xia Zhong-Jun, Li Yu-Hong, Wang Wei, He You-Jian, Pan Zhan-He, Jiang Wen-Qi, Guan Zhong-Zhen. [Clinical outcomes of patients with peripheral T-cell lymphoma (PTCL) treated by EPOCH regimen]. Ai Zheng. 2004 Aug;23(8):943–946. [PubMed] [Google Scholar]
- Shiota M., Nakamura S., Ichinohasama R., Abe M., Akagi T., Takeshita M., Mori N., Fujimoto J., Miyauchi J., Mikata A. Anaplastic large cell lymphomas expressing the novel chimeric protein p80NPM/ALK: a distinct clinicopathologic entity. Blood. 1995 Sep 1;86(5):1954–1960. [PubMed] [Google Scholar]
- Stein H., Foss H. D., Dürkop H., Marafioti T., Delsol G., Pulford K., Pileri S., Falini B. CD30(+) anaplastic large cell lymphoma: a review of its histopathologic, genetic, and clinical features. Blood. 2000 Dec 1;96(12):3681–3695. [PubMed] [Google Scholar]