Table 3.
Clinical characteristics and immunophenotypes of the diagnostic tumor specimens of AR-PCNSL from pre-cART vs cART eras. Both of these series had similarly distributed clinical and disease characteristics. Double-hit status, defined by coexpression of BCL-2 and MYC, was demonstrated in 26.8% of AR-PCNSL cases and without major differences between the pre-cART and cART eras. None of the tumors pre-cART scored positive for BCL-6, whereas 2 cases from patients previously treated with antiretroviral therapy were BCL-6+, consistent with the hypothesis that prior partial immune reconstitution may impact AIDS-related CNS lymphomagenesis. Nevertheless, we determined that overall, AR-PCNSL displays a remarkably uniform, nongerminal center immunophenotype that is distinct from the immunophenotype of PCNSL arising in the immunocompetent, a condition in which between 50% and 80% of cases coexpress MUM-1 and BCL-6,41 , 42 and in which 5%–15% are EBV+.43–45
| Characteristic | Pre-cART | cART Era |
|---|---|---|
| Total patients | 36 | 6 |
| Male | 35 (97%) | 5 (83%) |
| Median age (range) | 36 (27–50) | 36.5 (26–55) |
| Median KPS (range) | 30 (20–40) | 30 (20–50) |
| Median CD4+ cells/mm3 | 7 (0–157) | 5 (1–50) |
| Molecular markers | ||
| EBV+ | 35 (97%) | 6 (100%) |
| Median MIB-1+, no. ≥80% | 65, 8 | 65, 2 |
| BCL-2+ | 36 (100%) | 6 (100%) |
| MYC+ | 10 (28%) | 1 (17%) |
| CD10+ | 0 (0%) | 0 (0%) |
| BCL-6+ | 0 (0%) | 2 (33%) |
| MUM-1+ | 33 (92%) | 6 (100%) |