High incidence of Kaposi sarcoma-associated herpesvirus-related non-Hodgkin lymphoma in patients with HIV infection and multicentric Castleman disease.
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.
Oksenhendler
Eric
E
Department of Immunology and Hematology, Laboratory of Hematology, Hôpital Saint-Louis, 1 Ave Claude Vellefaux, 75010 Paris, France. eric.oksenhendler@sls.ap-hop-paris.fr
Boulanger
Emmanuelle
E
Galicier
Lionel
L
Du
Ming-Qing
MQ
Dupin
Nicolas
N
Diss
Tim C
TC
Hamoudi
Rifat
R
Daniel
Marie-Thérèse
MT
Agbalika
Félix
F
Boshoff
Chris
C
Clauvel
Jean-Pierre
JP
Isaacson
Peter G
PG
Meignin
Véronique
V
D000998:Antiviral Agents / Q000627:therapeutic use; D005871:Castleman Disease / Q000150:complications* / Q000235:genetics / Q000473:pathology; D015331:Cohort Studies; D005500:Follow-Up Studies; D015321:Gene Rearrangement; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000235:genetics; D019288:Herpesvirus 8, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007136:Immunoglobulins / Q000235:genetics; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology* / Q000235:genetics / Q000473:pathology / Q000821:virology; D009367:Neoplasm Staging; D012367:RNA, Viral / Q000302:isolation & purification; D012514:Sarcoma, Kaposi / Q000150:complications* / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D013997:Time Factors
D000998:Antiviral Agents; D007136:Immunoglobulins; D012367:RNA, Viral