HIV-associated Hematological Malignancies by Marcus Hentrich & Stefan K. Barta

Author:Marcus Hentrich & Stefan K. Barta
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

8.8 Conclusions

In general, HIV patients with indolent lymphoma demonstrate a benign course, similar to that of the HIV-negative population. The mean CD4+ cell counts are relatively higher as compared to those patients who develop intermediate- to high-grade lymphomas, and therefore, their genesis may not be as dependent on immune deregulation, with a notable exception. WM/LPL is reportedly more prevalent in the HIV population as compared with the non-HIV population. Given the increased risk of WM/LPL in PLWH, timely diagnosis and screening may be possible with heightened awareness of this entity.

In the majority of cases identified and outlined herein, mortality was not impacted by the presence of the indolent lymphoma. In cases requiring therapy, special attention to the prevention of opportunistic infection as a compound result of both therapy and the underlying HIV is appropriate, with the use of prophylactic antibiotics. Extremely immunosuppressive agents, such as fludarabine, should be avoided in favor of newer, less immunosuppressive agents given their availability. Since evidence regarding the safety and efficacy of novel therapies in the management of indolent NHL is lacking in the HIV population, inclusion of HIV patients in these ongoing and future studies is highly encouraged, with considered attention to CD4 counts and viral load for inclusion consideration.

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