Failure to eradicate AIDS-associated primary effusion lymphoma with high-dose chemotherapy and autologous stem cell reinfusion: case report and literature review.
Primary effusion lymphoma (PEL), also known as body cavity-based lymphoma, is a newly recognized AIDS-related malignancy that is etiopathologically linked to Kaposi's sarcoma (KS)-associated human herpes virus type 8 (HHV-8). PEL is characterized by presentation in serous body cavities without identifiable tumor masses. Tumor cells have high-grade morphologic features, an indeterminate immunophenotype, B-lineage genotype, and contain HHV-8 and often Epstein-Barr virus. PEL rarely responds to systemic chemotherapy. Herein, we describe what we believe is the first patient with AIDS-associated PEL to be treated with high-dose chemotherapy and autologous stem cell reinfusion. Treatment was well tolerated but the patient succumbed to progressive cancer. Our experience with this patient serves to underscore the high mortality rate associated with this unique neoplasm.
Virginia Mason Medical Center, Seattle, Washington 98111, USA.
Tom W
TW
Waddington
David M
DM
Aboulafia
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D016130:Immunophenotyping; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D011241:Prednisone / Q000008:administration & dosage; D016879:Salvage Therapy / Q000379:methods; D012514:Sarcoma, Kaposi / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D033581:Stem Cell Transplantation / Q000379:methods; D014182:Transplantation, Autologous / Q000379:methods; D017211:Treatment Failure; D014750:Vincristine / Q000008:administration & dosage; D019562:Viral Load
D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin; D007069:Ifosfamide; D011241:Prednisone