title: Clinical management of HIV-associated hematologic malignancies.
abstract: HIV is associated with an excess risk for lymphoid malignancies. Although the risk of lymphoma has decreased in HIV-infected individuals in the era of effective combination antiretroviral therapy, it remains high. Treatment outcomes have improved due to improvements in HIV and cancer therapeutics for the common HIV-associated lymphomas. R-CHOP/R-EPOCH are the standard of care for HIV-associated diffuse large B-cell lymphoma. HIV-infected patients with Burkitt lymphoma and good performance status should receive dose-intensive regimens. HIV-infected patients with primary central nervous system lymphoma can respond favorably to high-dose methotrexate-based therapy. In many cases, treatment and expected outcomes for HIV-infected patients with either Hodgkin or non-Hodgkin's lymphomas are very similar to HIV-negative patients. There is currently no standard treatment for HIV-associated multicentric Castleman disease or primary effusion lymphoma. For those hematologic cancers in which transplantation is part of standard care, this modality should be considered an option in those with well-controlled HIV infection.
authors.affiliation: a Division of Hematology/Oncology , San Francisco General Hospital , San Francisco , CA , USA.
authors.forename: Chia-Ching J
authors.initials: CC
authors.lastname: Wang
authors.affiliation: b Division of Hematology/Oncology, Helen Diller Comprehensive Cancer Center , University of California , San Francisco , CA , USA.
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Kaplan
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D019337:Hematologic Neoplasms / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000077594:Nivolumab; D015996:Survival Rate
chemical_list: D019380:Anti-HIV Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000077594:Nivolumab; C582435:pembrolizumab
keywords: Burkitt lymphoma; HIV; Hodgkin lymphoma; blood or marrow transplantation; multicentric Castleman disease; non-Hodgkin’s lymphoma; primary central nervous system lymphoma; primary effusion lymphoma