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Related Concept Videos

Immunodeficiency Diseases01:25

Immunodeficiency Diseases

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Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
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Primary lymphoid organs are pivotal in the formation, development, and maturation of lymphocytes, the white blood cells that serve as the backbone of our immune system. This crucial function underscores their fundamental role in maintaining our overall health and immunity. The two primary lymphoid organs of prime importance are the red bone marrow and the thymus.
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Secondary organs, including lymph nodes, the spleen, and mucosa-associated lymphoid tissue (MALT), work harmoniously to protect us from disease and infection.
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The adaptive immune response, a sophisticated defense mechanism, relies on the activation and differentiation of B lymphocytes, or B cells. These processes enable our bodies to mount a tailored response against specific pathogens such as bacteria, free virus particles, toxins, and parasites.
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Immunodeficiency-associated Hodgkin lymphoma.

Antonino Carbone1, Annunziata Gloghini2, Diego Serraino3

  • 1Pathology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, Aviano, Italy.

Expert Review of Hematology
|May 28, 2021
PubMed
Summary

Hodgkin lymphoma (HL) treatments in immunocompromised patients, including those with HIV/AIDS or post-transplant, are similar to the general population. Combination therapies and immune checkpoint inhibitors show promise for improved survival.

Keywords:
HIV-associated Hodgkin lymphomaHodgkin lymphomaimmunodeficiency-associated Hodgkin lymphomamanagementpost-transplant-associated Hodgkin lymphomatumor microenvironment

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Area of Science:

  • Oncology
  • Immunology
  • Hematology

Background:

  • Hodgkin lymphoma (HL) affects both the general population and immunocompromised individuals, including those with HIV/AIDS or post-transplant.
  • Understanding the tumor microenvironment and cellular characteristics is crucial for HL treatment.
  • HL in immunocompromised patients presents unique challenges and requires tailored therapeutic strategies.

Purpose of the Study:

  • To review current and novel treatment strategies for Hodgkin lymphoma in immunosuppressed patients, particularly persons living with HIV (PLWH).
  • To discuss the multidimensional characteristics of HL tumor cells and their microenvironment.
  • To evaluate the efficacy and safety of emerging therapies like immune checkpoint inhibitors.

Main Methods:

  • Systematic literature search of PubMed and MEDLINE databases for English articles published from 1989 to 2020.
  • Review of multidimensional characteristics of HL tumor cells and their microenvironment.
  • Analysis of conventional and novel treatment strategies for HL in immunosuppressed populations.

Main Results:

  • Standard HL treatments are generally applicable to post-transplant and HIV/AIDS-associated HL.
  • Combination of cART with anti-neoplastic and anti-rejection therapies has improved long-term survival in immunocompromised HL patients.
  • High-dose chemotherapy and autologous stem cell transplantation are effective salvage therapies for relapsed/refractory HL in PLWH.
  • Immune checkpoint inhibitors, such as pembrolizumab, are safe and effective in PLWH with HL, suggesting PD-1 ligand assessment is advisable.

Conclusions:

  • Standard HL treatments are effective for immunocompromised individuals.
  • Combined antiretroviral therapy (cART) with anti-neoplastic and anti-rejection therapies improves outcomes for HL patients with acquired immune deficiencies.
  • Emerging therapies like immune checkpoint inhibitors, particularly PD-1 inhibitors, offer new hope for relapsed/refractory HL in both general and immunocompromised populations, including PLWH.