title: Management and Outcomes of HIV-Associated Primary Effusion Lymphoma: A Single Center Experience.
abstract: Primary effusion lymphoma (PEL) is a rare malignancy usually associated with HIV infection. Management and outcomes are poorly understood.
  
  
  
  The medical records of all patients diagnosed with HIV-associated PEL at our institution between 1999 and 2014 were reviewed. Patients were followed till death, treatment failure or loss of follow-up.
  
  
  
  Twelve patients with PEL were identified during the 15 year study period; 9 had HIV infection. All 9 were male; median age was 45 years. All presented with local symptoms and were diagnosed with PEL a median of 11 years after HIV diagnosis. Location was pleural (3), pericardial (3), peritoneal (1) and extracavitatory (2). By definition, all had Ann Arbor stage 4 at diagnosis. Median follow-up was 34 months. Two patients had poor performance status and were unable to get chemotherapy. Seven patients had a complete remission (CR) and two died within 1 month of diagnosis. The median CD4 levels at PEL diagnosis in patients with poor versus good outcomes were 54 cells/mm3 (range, 26-82 cells/mm3) and 211 cells/mm3 (range, 73-800 cells/mm3). In contrast, the median lactate dehydrogenase (LDH) levels at PEL diagnosis with poor versus good prognosis were 1074 U/L (range, 703-1445 U/L) and 283 U/L (range, 156-760 U/L).
  
  
  
  Given its rarity, our knowledge of PEL relies solely on case reports and case series. Prompt HAART and chemotherapy may be effective in HIV- associated PEL and good outcomes are possible. LDH and CD4 may be possible prognostic factors in PEL.
authors: Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: guptaarjun90@gmail.com.
authors: Arjun
authors: A
authors: Gupta
authors: Department of Hematology Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Shiraj
authors: S
authors: Sen
authors: Department of Pharmacology, Parkland Health and Hospital System, Dallas, TX.
authors: Eileen
authors: E
authors: Marley
authors: Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Weina
authors: W
authors: Chen
authors: Department of Hematology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Harris V
authors: HV
authors: Naina
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D054685:Lymphoma, Primary Effusion / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load
keywords: Bortezomib; Epidemiology; Kaposi sarcoma-associated herpesvirus; Management; Outcomes; Primary effusion lymphoma