title: Peripheral T-cell lymphoma in HIV-infected patients: a study of 17 cases in the combination antiretroviral therapy era.
abstract: Most cases of human immunodeficiency virus (HIV)-associated non-Hodgkin Lymphoma (NHL) are of B-cell origin; T-cell NHLs are rarely reported. Within a single centre prospective cohort of 370 HIV-NHL, 17 (5%) were of T-cell origin (82% male; median age, 39 years). Median CD4+ cell count was 0·194 × 10(9) /l and 41% had undetectable plasma HIV-RNA at lymphoma diagnosis. All patients received combination antiretroviral therapy during chemotherapy. All histological samples were centrally reviewed. The distribution of the histological subtypes differed from the general population with absence of angioimmunoblastic subtype. Lymphoma was disseminated in 14 patients, and seven patients had performance status >2. All patients received full-dose chemotherapy: eight standard and nine intensive regimens. Two patients who received intensive chemotherapy died during therapy. The complete remission rate was 53%; 62·5% with standard therapy and 44% with intensive therapy. After a median follow-up of 7·2 years, the median overall survival was 9·4 months. Most deaths (85%) occurred within the first year following diagnosis, as a consequence of lymphoma progression in 10/13 cases. In this rare but severe complication of HIV infection the use of intensive chemotherapy does not appear to be beneficial for response, with increased toxicity.
authors.affiliation: Département d'Immunologie Clinique, Hôpital Saint-Louis, AP-HP, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Gilardin
authors.forename: Christiane
authors.initials: C
authors.lastname: Copie-Bergman
authors.forename: Lionel
authors.initials: L
authors.lastname: Galicier
authors.forename: Véronique
authors.initials: V
authors.lastname: Meignin
authors.forename: Josette
authors.initials: J
authors.lastname: Brière
authors.forename: Julie F
authors.initials: JF
authors.lastname: Timsit
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouchaud
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaulard
authors.forename: Eric
authors.initials: E
authors.lastname: Oksenhendler
authors.forename: Laurence
authors.initials: L
authors.lastname: Gérard
mesh_terms: D000328:Adult; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000209:etiology; D016411:Lymphoma, T-Cell, Peripheral / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult