1. High incidence of Kaposi sarcoma-associated herpesvirus-related non-Hodgkin lymphoma in patients with HIV infection and multicentric Castleman disease.
- Author
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Oksenhendler E, Boulanger E, Galicier L, Du MQ, Dupin N, Diss TC, Hamoudi R, Daniel MT, Agbalika F, Boshoff C, Clauvel JP, Isaacson PG, and Meignin V
- Subjects
- Antiviral Agents therapeutic use, Castleman Disease genetics, Castleman Disease pathology, Cohort Studies, Follow-Up Studies, HIV Infections drug therapy, HIV Infections genetics, Herpesvirus 8, Human genetics, Humans, Immunoglobulins genetics, Lymphoma, Non-Hodgkin genetics, Lymphoma, Non-Hodgkin pathology, Lymphoma, Non-Hodgkin virology, Neoplasm Staging, RNA, Viral isolation & purification, Sarcoma, Kaposi drug therapy, Sarcoma, Kaposi genetics, Sarcoma, Kaposi pathology, Time Factors, Castleman Disease complications, Gene Rearrangement, HIV isolation & purification, HIV Infections complications, Herpesvirus 8, Human isolation & purification, Lymphoma, Non-Hodgkin etiology, Sarcoma, Kaposi complications
- Abstract
Multicentric Castleman disease (MCD) is a distinct type of lymphoproliferative disorder associated with inflammatory symptoms and interleukin 6 (IL-6) dysregulation. In the context of human immunodeficiency virus (HIV) infection, MCD is associated with Kaposi sarcoma-associated herpesvirus, also called human herpesvirus type 8 (KSHV/HHV8). Within a prospective cohort study on 60 HIV-infected patients with MCD, and a median follow-up period of 20 months, 14 patients developed KSHV/HHV8-associated non-Hodgkin lymphoma (NHL): 3 "classic" KSHV/HHV8(+) Epstein-Barr virus-positive (EBV(+)) primary effusion lymphoma (PEL), 5 KSHV/HHV8(+) EBV(-) visceral large cell NHL with a PEL-like phenotype, and 6 plasmablastic lymphoma/leukemia (3/3 KSHV/HHV8(+) EBV(-)). The NHL incidence observed in this cohort study (101/1000 patient-years) is about 15-fold what is expected in the general HIV(+) population. MCD-associated KSHV/HHV8(+) NHL fell into 2 groups, suggesting different pathogenesis. The plasmablastic NHL likely represents the expansion of plasmablastic microlymphoma from the MCD lesion and progression toward aggressive NHL. In contrast, the PEL and PEL-like NHL may implicate a different original infected cell whose growth is promoted by the cytokine-rich environment of the MCD lesions.
- Published
- 2002
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