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[Lymphomas in children infected with HIV-1]
V Gandemer1, V Verkarre, P Quartier
1Unité d'immunologie-hématologie pédiatrique, hôpital Necker-Enfants-malades, Paris, France.
Purpose:
To describe the features of lymphoma in human immunodeficiency virus (HIV)-infected children, their treatments and the outcome of patients.
Results:
We analyzed seven HIV-infected children (four by mother-to-child transmission and three by transfusion) (25 months to 18.5 years old) with lymphoma (one Hodgkin's disease and six non-Hodgkin's lymphomas). All of them presented with a severe immunodepression and a high viral load. Five of six were high grade-B cell non-Hodgkin's lymphoma of large-cell histologies (immunoblastic or centroblastic). Five were extranodular disease and three were metastatic at diagnosis. Epstein-Barr virus was detected in four tumors. Five of seven received a multiagent chemotherapy. Toxicity was high. Treatment for the skin T lymphoma consisted of radiation therapy. Five children were complete responders (with survival three years, 2.5 years, 12, 18 and 18 months) and two died of progression of lymphoma (four and five months later).
Conclusion:
Incidence of lymphoma is increased in HIV-infected children. Anticancer chemotherapy regimens that include aggressive supportive care and concomitant antiretroviral therapy or immunotherapy may yield high survival rates.