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Published on: January 12, 2024
HIV-associated lymphoma: the evidence for treating aggressively but with caution
1Albert Einstein College of Medicine, Department of Oncology, Montefiore Medical Center, Weiler Division, Bronx, New York 10461, USA. jsparano@montefiore.org
Purpose Of The Review:
The aim of this article is to review key reports regarding the biology and management of HIV-associated lymphoma during the past year.
Recent Findings:
The use of highly active antiretroviral therapy (HAART) has been associated with a reduced risk of primary cerebral and systemic non-Hodgkin's lymphoma, a stable or slightly increased risk of Hodgkin's lymphoma, and improved prognosis for those who develop HIV-associated non-Hodgkin's lymphoma or Hodgkin's lymphoma. Emerging evidence suggests that patients with HIV-associated lymphoma should be treated in a similar manner as immunocompetent patients with the same disease, especially if the CD4 count is 50-100 cells/mul or higher. Use of the anti-CD20 monoclonal antibody rituximab in combination with chemotherapy appears to result in improved control of B-cell lymphoma, but may come at the expense of an increased risk of bacterial and viral infections.
Summary:
Although the evidence currently supports an aggressive and curative approach for the management of HIV-associated lymphoma, clinicians must be vigilant about implementing infection prophylaxis and promptly recognizing, diagnosing, and treating bacterial, parasitic, fungal, and viral infections that may occur as a consequence of therapy.
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