AIDS-related lymphoma

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AIDS-related lymphoma
Specialty Hematology and oncology

AIDS-related lymphoma describes lymphomas occurring in patients with acquired immunodeficiency syndrome (AIDS). [1] [2]

Contents

A lymphoma is a type of cancer arising from lymphoid cells. In AIDS, the incidence of non-Hodgkin's lymphoma, primary cerebral lymphoma and Hodgkin's disease are all increased. There are three different varieties of AIDS-related lymphoma: Diffuse large B-cell lymphoma, B-cell immunoblastic lymphoma, and Burkitt's lymphoma (small non-cleaved cell lymphoma). [3]

Signs and symptoms

The histologic classification of the lymphoma, as well as the locations and severity of the disease, all influence the clinical presentation of HIV-related lymphomas. [4] HIV-related lymphomas are more likely to present with advanced stage disease, constitutional symptoms (also known as "B" symptoms; fever, weight loss, and night sweats), extranodal involvement, or disease involving unusual locations (such as the body cavity or soft tissue) than lymphomas in the HIV-negative population. [5] [6]

HIV-related lymphomas can present with a variety of clinical symptoms, including organomegaly, lymphadenopathy, and/or constitutional symptoms. Unknown fever, cytopenias, tumor lysis syndrome (including lactic acidosis, hyperkalemia, hyperuricemia, hypocalcemia, hyperphosphatemia, and elevated lactate dehydrogenase), and other isolated laboratory abnormalities (such as hypercalcemia) are observed in certain patients. [7]

Causes

HIV-positive individuals' lymphomas vary widely and can be classified into several histologic subtypes. [8] The two primary lymphoma types that develop in HIV-positive individuals are non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL). [9]

Diffuse large B-cell lymphoma is a highly aggressive type of B-cell lymphoma. It is distinguished by the widespread proliferation of large neoplastic B lymphocytes with nuclei that are equal to or larger than normal histiocytic nuclei. [10] The illness manifests with B symptoms at an advanced stage of the illness. It mostly affects patients who are severely immunosuppressed and can occur at nodal or extranodal sites, with the gastrointestinal tract being the most common site. [11] [12] It makes up between 45 and 50 percent of all lymphomas seen in this group, making it the most prevalent AIDS-associated lymphoma subtype. [13] [14] All ages are affected by DLBCL, which typically manifests as a rapidly growing lymph node mass in the neck or abdomen. [15] Up to 40% of patients have extranodal extramedullary disease, and about 30% of patients exhibit B symptoms. [16]

The second most prevalent NHL subtype that affects HIV-positive individuals with a comparatively high CD4 cell count is Burkitt's lymphoma. Patients typically have elevated lactate dehydrogenase levels and poor performance status. [15] The central nervous system is involved in 8 to 28% of cases, with extranodal involvement occurring more frequently. [11] It usually manifests at a younger age and with CD4 cell counts greater than 200 cells/μL. [17] It develops quickly and is a kind of tumor that starts from B cells. In addition, it is fatal if untreated. [18] Burkitt's lymphoma is linked to a high incidence of oral cavity involvement and makes up 10-15% of AIDS-defining lymphomas. [15] Three clinical subtypes of Burkitt's lymphoma have been identified: endemic, sporadic, and immunodeficiency-related. [19] Thirty to forty percent of AIDS-related NHL cases are Burkitt's lymphoma subtype, which is most prevalent in HIV/AIDS patients. [18]

Primary central nervous system lymphoma (PCNSL) is a subtype of NHL that impacts the eyes, brain, spine, and cerebrospinal fluid in the central nervous system. [20] It appears in patients who have severe immune suppression; since the advent of highly active antiretroviral therapy, its incidence has declined in these patients. The majority of PCNSL linked to HIV is Epstein-Barr virus positive. [15] Furthermore, unlike HIV-negative PCNSL, patients typically present with multiple brain lesions and/or changes in mental status or focal neurologic symptoms. [14] [21] Changes in mental state, intracranial pressure symptoms (headache, nausea, vomiting, papilledema), and local compression symptoms (epilepsy, memory loss, unstable gait, visual impairment, slurred speech) are the most common symptoms of PCNSL. [22]

Primary effusion lymphoma is a distinct subtype of aggressive B-cell NHL. It is brought on by HHV8, commonly referred to as KSHV, or Kaposi sarcoma-associated herpesvirus. [23] [24] It is uncommon, making up 0.3% of NHL in the general population and 4% of NHL linked to HIV. Between 60 and 90 percent of cases of primary effusion lymphoma have EBV co-infection, although its pathogenesis is unknown. [15] There are malignant lymphomatous effusions in the pericardium, peritoneal cavity, and pleural space. [25]

Plasmablastic lymphoma (PBL) originates from terminally differentiated, activated B-cells at the post-germinal center that are changing from immunoblasts to plasma cells. [15] About 2% of all AIDS-associated lymphomas are PBL-associated lymphomas. [26] HIV infection is closely associated with this uncommon form of lymphoma, which primarily affects the oral cavity. [27] With a widespread proliferation of massive neoplastic cells that resemble B-cell immunoblasts but have the immunophenotype of plasma cells, it is incredibly aggressive. [28]

Hodgkin lymphoma (HL) is one of the most common cancers that do not indicate AIDS, and since highly active antiretroviral therapy was introduced, its incidence has increased. It is a germinal center-derived cell that produces Hodgkin Reed–Sternberg (HRS) cells. [15] It is more common in immunocompromised individuals, especially those with HIV. [29] Compared to mild immune compromise, the incidence of HL is lower in states of extreme immunodeficiency. It's possible that there was insufficient immunological contact between non-neoplastic inflammatory cells and HRS cells. [30]

Mechanism

HIV-positive patients have a higher incidence of malignancies for a variety of reasons. These consist of inflammation, cytokine dysregulation, and persistent antigenic stimulation. [15] Moreover, oncogenic viruses are more likely to infect HIV/AIDS patients. [31] Thus, a variety of factors, such as a compromised immune system, genetic changes, viral infection, and persistent B cell activation, contribute to the pathogenesis of HIV/AIDS-associated lymphoma. [15]

Related Research Articles

<span class="mw-page-title-main">Non-Hodgkin lymphoma</span> Type of cancer of lymph nodes

Non-Hodgkin lymphoma (NHL), also known as non-Hodgkin's lymphoma, is a group of blood cancers that includes all types of lymphomas except Hodgkin lymphomas. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness. Other symptoms may include bone pain, chest pain, or itchiness. Some forms are slow-growing while others are fast-growing.

<span class="mw-page-title-main">Lymphoma</span> Hematologic cancer that affects lymphocytes

Lymphoma is a group of blood and lymph tumors that develop from lymphocytes. The name typically refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlarged lymph nodes, fever, drenching sweats, unintended weight loss, itching, and constantly feeling tired. The enlarged lymph nodes are usually painless. The sweats are most common at night.

<span class="mw-page-title-main">Burkitt lymphoma</span> Cancer of the lymphatic system

Burkitt lymphoma is a cancer of the lymphatic system, particularly B lymphocytes found in the germinal center. It is named after Denis Parsons Burkitt, the Irish surgeon who first described the disease in 1958 while working in equatorial Africa. It is a highly aggressive form of cancer which often, but not always, manifests after a person develops acquired immunodeficiency from infection with Epstein-Barr Virus or Human Immunodeficiency Virus (HIV).

<span class="mw-page-title-main">Tumors of the hematopoietic and lymphoid tissues</span> Tumors that affect the blood, bone marrow, lymph, and lymphatic system

Tumors of the hematopoietic and lymphoid tissues or tumours of the haematopoietic and lymphoid tissues are tumors that affect the blood, bone marrow, lymph, and lymphatic system. Because these tissues are all intimately connected through both the circulatory system and the immune system, a disease affecting one will often affect the others as well, making aplasia, myeloproliferation and lymphoproliferation closely related and often overlapping problems. While uncommon in solid tumors, chromosomal translocations are a common cause of these diseases. This commonly leads to a different approach in diagnosis and treatment of hematological malignancies. Hematological malignancies are malignant neoplasms ("cancer"), and they are generally treated by specialists in hematology and/or oncology. In some centers "hematology/oncology" is a single subspecialty of internal medicine while in others they are considered separate divisions. Not all hematological disorders are malignant ("cancerous"); these other blood conditions may also be managed by a hematologist.

<span class="mw-page-title-main">Adult T-cell leukemia/lymphoma</span> Human disease

Adult T-cell leukemia/lymphoma is a rare cancer of the immune system's T-cells caused by human T cell leukemia/lymphotropic virus type 1 (HTLV-1). All ATL cells contain integrated HTLV-1 provirus further supporting that causal role of the virus in the cause of the neoplasm. A small amount of HTLV-1 individuals progress to develop ATL with a long latency period between infection and ATL development. ATL is categorized into 4 subtypes: acute, smoldering, lymphoma-type, chronic. Acute and Lymphoma-type are known to particularity be aggressive with poorer prognosis.

<span class="mw-page-title-main">Primary effusion lymphoma</span> Medical condition

Primary effusion lymphoma (PEL) is classified as a diffuse large B cell lymphoma. It is a rare malignancy of plasmablastic cells that occurs in individuals that are infected with the Kaposi's sarcoma-associated herpesvirus. Plasmablasts are immature plasma cells, i.e. lymphocytes of the B-cell type that have differentiated into plasmablasts but because of their malignant nature do not differentiate into mature plasma cells but rather proliferate excessively and thereby cause life-threatening disease. In PEL, the proliferating plasmablastoid cells commonly accumulate within body cavities to produce effusions, primarily in the pleural, pericardial, or peritoneal cavities, without forming a contiguous tumor mass. In rare cases of these cavitary forms of PEL, the effusions develop in joints, the epidural space surrounding the brain and spinal cord, and underneath the capsule which forms around breast implants. Less frequently, individuals present with extracavitary primary effusion lymphomas, i.e., solid tumor masses not accompanied by effusions. The extracavitary tumors may develop in lymph nodes, bone, bone marrow, the gastrointestinal tract, skin, spleen, liver, lungs, central nervous system, testes, paranasal sinuses, muscle, and, rarely, inside the vasculature and sinuses of lymph nodes. As their disease progresses, however, individuals with the classical effusion-form of PEL may develop extracavitary tumors and individuals with extracavitary PEL may develop cavitary effusions.

<span class="mw-page-title-main">Primary central nervous system lymphoma</span> Medical condition

Primary central nervous system lymphoma (PCNSL), also termed primary diffuse large B-cell lymphoma of the central nervous system (DLBCL-CNS), is a primary intracranial tumor appearing mostly in patients with severe immunodeficiency. It is a subtype and one of the most aggressive of the diffuse large B-cell lymphomas.

<span class="mw-page-title-main">B-cell lymphoma</span> Blood cancer that affects B-type white blood cells

The B-cell lymphomas are types of lymphoma affecting B cells. Lymphomas are "blood cancers" in the lymph nodes. They develop more frequently in older adults and in immunocompromised individuals.

<span class="mw-page-title-main">Diffuse large B-cell lymphoma</span> Type of blood cancer

Diffuse large B-cell lymphoma (DLBCL) is a cancer of B cells, a type of lymphocyte that is responsible for producing antibodies. It is the most common form of non-Hodgkin lymphoma among adults, with an annual incidence of 7–8 cases per 100,000 people per year in the US and UK. This cancer occurs primarily in older individuals, with a median age of diagnosis at ~70 years, although it can occur in young adults and, in rare cases, children. DLBCL can arise in virtually any part of the body and, depending on various factors, is often a very aggressive malignancy. The first sign of this illness is typically the observation of a rapidly growing mass or tissue infiltration that is sometimes associated with systemic B symptoms, e.g. fever, weight loss, and night sweats.

Intraocular lymphoma is a rare malignant form of eye cancer. Intraocular lymphoma may affect the eye secondarily from a metastasis from a non-ocular tumor or may arise within the eye primarily. PIOL is a subset of primary central nervous system lymphoma (PCNSL). PCNSL are most commonly a diffuse large B-cell immunohistologic subtype of non-Hodgkin's lymphoma according to the World Health Organization (WHO) classification of lymphomas. The most common symptoms of PIOL include blurred or decreased vision due to tumor cells in the vitreous. Most cases of PIOL eventuate to central nervous system involvement (PCNSL) while only 20% of PCNSL lead to intraocular (PIOL) involvement. PIOL and PCNSL remain enigmas because both structures are immunologically privileged sites and so do not normally have immune cells trafficking through these structures. What is more, while the vast majority of PCNSL in patients with acquired immune deficiency syndrome (AIDS) is related to the Epstein-Barr virus (EBV), the development of PCNSL and PIOL in immunocompetent patients is unknown and shows no general relation to infectious DNAs.

<span class="mw-page-title-main">Aggressive lymphoma</span> Medical condition

Aggressive lymphoma, also known as high-grade lymphoma, is a group of fast growing non-Hodgkin lymphoma.

<span class="mw-page-title-main">Panobinostat</span> Chemical compound

Panobinostat, sold under the brand name Farydak, is a medication used for the treatment of multiple myeloma. It is a hydroxamic acid and acts as a non-selective histone deacetylase inhibitor.

<span class="mw-page-title-main">Hodgkin lymphoma</span> Type of blood and immune-system cancer

Hodgkin lymphoma (HL) is a type of lymphoma in which cancer originates from a specific type of white blood cell called lymphocytes, where multinucleated Reed–Sternberg cells are present in the patient's lymph nodes. The condition was named after the English physician Thomas Hodgkin, who first described it in 1832. Symptoms may include fever, night sweats, and weight loss. Often, nonpainful enlarged lymph nodes occur in the neck, under the arm, or in the groin. Persons affected may feel tired or be itchy.

<span class="mw-page-title-main">Signs and symptoms of HIV/AIDS</span>

The stages of HIV infection are acute infection, latency, and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, swollen lymph nodes, inflammation of the throat, rash, muscle pain, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts, various opportunistic infections, cancers, and other conditions.

<span class="mw-page-title-main">Plasmablastic lymphoma</span> Type of large B-cell lymphoma

Plasmablastic lymphoma (PBL) is a type of large B-cell lymphoma recognized by the World Health Organization (WHO) in 2017 as belonging to a subgroup of lymphomas termed lymphoid neoplasms with plasmablastic differentiation. The other lymphoid neoplasms within this subgroup are: plasmablastic plasma cell lymphoma ; primary effusion lymphoma that is Kaposi's sarcoma-associated herpesvirus positive or Kaposi's sarcoma-associated Herpesvirus negative; anaplastic lymphoma kinase-positive large B-cell lymphoma; and human herpesvirus 8-positive diffuse large B-cell lymphoma, not otherwise specified. All of these lymphomas are malignancies of plasmablasts, i.e. B-cells that have differentiated into plasmablasts but because of their malignant nature: fail to differentiate further into mature plasma cells; proliferate excessively; and accumulate in and injure various tissues and organs.

Large B-cell lymphoma arising in HHV8-associated multicentric Castleman's disease is a type of large B-cell lymphoma, recognized in the WHO 2008 classification. It is sometimes called the plasmablastic form of multicentric Castleman disease. It has sometimes been confused with plasmablastic lymphoma in the literature, although that is a dissimilar specific entity. It has variable CD20 expression and unmutated immunoglobulin variable region genes.

<span class="mw-page-title-main">HHV-8-associated MCD</span> Disease subtype

Human herpesvirus 8 associated multicentric Castleman disease is a subtype of Castleman disease, a group of rare lymphoproliferative disorders characterized by lymph node enlargement, characteristic features on microscopic analysis of enlarged lymph node tissue, and a range of symptoms and clinical findings.

Epstein–Barr virus–associated lymphoproliferative diseases are a group of disorders in which one or more types of lymphoid cells, i.e. B cells, T cells, NK cells, and histiocytic-dendritic cells, are infected with the Epstein–Barr virus (EBV). This causes the infected cells to divide excessively, and is associated with the development of various non-cancerous, pre-cancerous, and cancerous lymphoproliferative disorders (LPDs). These LPDs include the well-known disorder occurring during the initial infection with the EBV, infectious mononucleosis, and the large number of subsequent disorders that may occur thereafter. The virus is usually involved in the development and/or progression of these LPDs although in some cases it may be an "innocent" bystander, i.e. present in, but not contributing to, the disease.

<span class="mw-page-title-main">Indolent lymphoma</span> Medical condition

Indolent lymphoma, also known as low-grade lymphoma, is a group of slow-growing non-Hodgkin lymphomas (NHLs). Because they spread slowly, they tend to have fewer signs and symptoms when first diagnosed and may not require immediate treatment. Symptoms can include swollen but painless lymph nodes, unexplained fever, and unintended weight loss.

Mature T-cell lymphoma, also called peripheral T-cell lymphoma, is a group of rare, aggressive lymphomas that develop from mature white blood cells and originate from lymphoid tissues outside of the bone marrow. Mature T-cell lymphoma is under the category of non-Hodgkin lymphoma. Mature T-cell lymphomas account for 10% to 15% of all lymphomas and is more common in Asia than in Europe and America. Its common subtypes include angioimmunoblastic T-cell lymphoma, anaplastic large cell lymphoma and peripheral T-cell lymphoma not otherwise specified. While different subtypes have variable symptoms, common symptoms include enlarged painless lymph nodes, fever, weight loss, rash and night sweats.

References

  1. ↑ Besson C, Goubar A, Gabarre J, et al. (October 2001). "Changes in AIDS-related lymphoma since the era of highly active antiretroviral therapy". Blood. 98 (8): 2339–44. doi: 10.1182/blood.V98.8.2339 . PMID   11588028.
  2. ↑ Rigolet A, Bossi P, Caumes E, et al. (September 2001). "Caractéristiques épidémiologiques et évolution de l'incidence des lymphomes cérébraux primitifs observés chez 80 patients infectés par le VIH entre 1983 et 1999" [Epidemiological features and incidence trends of primary cerebral lymphomas observed in 80 HIV-infected patients from 1983 to 1999]. Pathologie-biologie (in French). 49 (7): 572–5. doi:10.1016/S0369-8114(01)00206-1. PMID   11642021.
  3. ↑ "AIDS-Related Lymphoma Treatment (PDQ®) - National Cancer Institute". Cancer.gov. 2012-05-18. Retrieved 2012-05-30.
  4. ↑ "UpToDate". UpToDate. Retrieved February 10, 2024.
  5. ↑ Heise, Walter (2010). "GI-lymphomas in immunosuppressed patients (organ transplantation; HIV)". Best Practice & Research Clinical Gastroenterology. Elsevier BV. 24 (1): 57–69. doi:10.1016/j.bpg.2010.01.001. ISSN   1521-6918. PMID   20206109.
  6. ↑ Noy, Ariela (2020). "HIV Lymphoma and Burkitts Lymphoma". The Cancer Journal. Ovid Technologies (Wolters Kluwer Health). 26 (3): 260–268. doi:10.1097/ppo.0000000000000448. ISSN   1540-336X. PMC   9302611 . PMID   32496459.
  7. ↑ Abellán-Martínez, Javier; Guerra-Vales, Juan-Manuel; Fernández-Cotarelo, María-José; González-Alegre, María-Teresa (2009). "Evolution of the incidence and aetiology of fever of unknown origin (FUO), and survival in HIV-infected patients after HAART (Highly Active Antiretroviral Therapy)". European Journal of Internal Medicine. Elsevier BV. 20 (5): 474–477. doi:10.1016/j.ejim.2009.01.004. ISSN   0953-6205. PMID   19712847.
  8. ↑ Carroll, Virginia; Garzino-Demo, Alfredo (June 29, 2015). "HIV-associated lymphoma in the era of combination antiretroviral therapy: shifting the immunological landscape". Pathogens and Disease. Oxford University Press (OUP). 73 (7): ftv044. doi:10.1093/femspd/ftv044. ISSN   2049-632X. PMC   4607737 . PMID   26121984.
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  10. ↑ Xie, Yi; Pittaluga, Stefania; Jaffe, Elaine S. (2015). "The Histological Classification of Diffuse Large B-cell Lymphomas". Seminars in Hematology. Elsevier BV. 52 (2): 57–66. doi:10.1053/j.seminhematol.2015.01.006. ISSN   0037-1963. PMC   4374126 . PMID   25805585.
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  12. ↑ Magangane, Pumza S.; Mohamed, Zainab; Naidoo, Richard (February 24, 2020). "Diffuse large B-cell lymphoma in a high human immunodeficiency virus (HIV) prevalence, low-resource setting". South African Journal of Oncology. AOSIS. 4. doi:10.4102/sajo.v4i0.104. ISSN   2518-8704.
  13. ↑ Wu, Dedong; Chen, Chen; Zhang, Mingzhi; Li, Zhaoming; Wang, Suqian; Shi, Jijing; Zhang, Yu; Yao, Dingzhu; Hu, Shuang (March 29, 2019). "The clinical features and prognosis of 100 AIDS-related lymphoma cases". Scientific Reports. Springer Science and Business Media LLC. 9 (1): 5381. Bibcode:2019NatSR...9.5381W. doi:10.1038/s41598-019-41869-9. ISSN   2045-2322. PMC   6441082 . PMID   30926889.
  14. 1 2 Meister, Anne; Hentrich, Marcus; Wyen, Christoph; Hübel, Kai (May 22, 2018). "Malignant lymphoma in the <scp>HIV</scp>-positive patient". European Journal of Haematology. Wiley. 101 (1): 119–126. doi:10.1111/ejh.13082. ISSN   0902-4441. PMID   29663523.
  15. 1 2 3 4 5 6 7 8 9 Berhan, Ayenew; Bayleyegn, Biruk; Getaneh, Zegeye (2022). "HIV/AIDS Associated Lymphoma: Review". Blood and Lymphatic Cancer: Targets and Therapy. Informa UK Limited. 12: 31–45. doi: 10.2147/blctt.s361320 . ISSN   1179-9889. PMC   9063794 . PMID   35517869.
  16. ↑ Shah, Hina J.; Keraliya, Abhishek R.; Jagannathan, Jyothi P.; Tirumani, Sree Harsha; Lele, Vikram R.; DiPiro, Pamela J. (2017). "Diffuse Large B-Cell Lymphoma in the Era of Precision Oncology: How Imaging Is Helpful". Korean Journal of Radiology. The Korean Society of Radiology. 18 (1): 54–70. doi:10.3348/kjr.2017.18.1.54. ISSN   1229-6929. PMC   5240489 . PMID   28096718.
  17. ↑ Pinisetti, S.; Nalabolu, G. R.; Uvr, C.; Tadi, D. P. (2013). "HIV Associated Intra–oral Burkitt's Lymphoma: A Case Report". Journal of Clinical and Diagnostic Research. JCDR Research and Publications. 7 (12): 3088–3089. doi:10.7860/jcdr/2013/6715.3862. ISSN   2249-782X. PMC   3919292 . PMID   24551737.
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  19. ↑ Dozzo, Massimo; Carobolante, Francesca; Donisi, Pietro Maria; Scattolin, Annamaria; Maino, Elena; Sancetta, Rosaria; Viero, Piera; Bassan, Renato (2016). "Burkitt lymphoma in adolescents and young adults: management challenges". Adolescent Health, Medicine and Therapeutics. Informa UK Limited. 8: 11–29. doi: 10.2147/ahmt.s94170 . ISSN   1179-318X. PMC   5207020 . PMID   28096698.
  20. ↑ Grommes, Christian; DeAngelis, Lisa M. (July 20, 2017). "Primary CNS Lymphoma". Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO). 35 (21): 2410–2418. doi:10.1200/jco.2017.72.7602. ISSN   0732-183X. PMC   5516483 . PMID   28640701.
  21. ↑ Dunleavy, Kieron; Wilson, Wyndham H. (April 5, 2012). "How I treat HIV-associated lymphoma". Blood. American Society of Hematology. 119 (14): 3245–3255. doi:10.1182/blood-2011-08-373738. ISSN   0006-4971. PMC   3321851 . PMID   22337719.
  22. ↑ Zhao, Hui; Ma, Miao; Zhang, Limin; Zheng, Guanghui; Lv, Hong; Liu, Jie; Li, Xiao; Song, Bei; Zhang, Guojun (May 7, 2019). "Diagnosis of central nervous system lymphoma via cerebrospinal fluid cytology: a case report". BMC Neurology. Springer Science and Business Media LLC. 19 (1): 90. doi: 10.1186/s12883-019-1317-3 . ISSN   1471-2377. PMC   6505083 . PMID   31064334.
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  24. ↑ Antar, A; El Hajj, H; Jabbour, M; Khalifeh, I; EL-Merhi, F; Mahfouz, R; Bazarbachi, A (March 7, 2014). "Primary effusion lymphoma in an elderly patient effectively treated by lenalidomide: case report and review of literature". Blood Cancer Journal. Springer Science and Business Media LLC. 4 (3): e190. doi:10.1038/bcj.2014.6. ISSN   2044-5385. PMC   3972705 . PMID   24608734.
  25. ↑ Narkhede, Mayur; Arora, Shagun; Ujjani, Chaitra (2018). "Primary effusion lymphoma: current perspectives". OncoTargets and Therapy. Informa UK Limited. 11: 3747–3754. doi: 10.2147/ott.s167392 . ISSN   1178-6930. PMC   6029609 . PMID   29988764.
  26. ↑ Castillo, Jorge J.; Bibas, Michele; Miranda, Roberto N. (April 9, 2015). "The biology and treatment of plasmablastic lymphoma". Blood. American Society of Hematology. 125 (15): 2323–2330. doi:10.1182/blood-2014-10-567479. ISSN   0006-4971. PMID   25636338.
  27. ↑ Elyamany, Ghaleb; Al Mussaed, Eman; Alzahrani, Ali Matar (2015). "Plasmablastic Lymphoma: A Review of Current Knowledge and Future Directions". Advances in Hematology. Hindawi Limited. 2015: 1–11. doi: 10.1155/2015/315289 . ISSN   1687-9104. PMC   4555447 . PMID   26357515.
  28. ↑ Broccoli, Alessandro; Nanni, Laura; Stefoni, Vittorio; Agostinelli, Claudio; Argnani, Lisa; Cavo, Michele; Zinzani, Pier Luigi (June 8, 2018). "A patient with plasmablastic lymphoma achieving long-term complete remission after thalidomide-dexamethasone induction and double autologous stem cell transplantation: a case report". BMC Cancer. Springer Science and Business Media LLC. 18 (1): 645. doi: 10.1186/s12885-018-4561-9 . ISSN   1471-2407. PMC   5992724 . PMID   29879938.
  29. ↑ Ul-Haq, Ikram; Dalla Pria, Alessia; Suardi, Elisa; Pinato, David J.; Froeling, Fieke; Forni, John; Randell, Paul; Bower, Mark (March 13, 2018). "Blood Epstein–Barr virus DNA does not predict outcome in advanced HIV-associated Hodgkin lymphoma". Medical Oncology. Springer Science and Business Media LLC. 35 (4). doi:10.1007/s12032-018-1099-2. ISSN   1357-0560. PMID   29536181.
  30. ↑ Grogg, K L; Miller, R F; Dogan, A (December 20, 2006). "HIV infection and lymphoma". Journal of Clinical Pathology. BMJ. 60 (12): 1365–1372. doi:10.1136/jcp.2007.051953. ISSN   0021-9746. PMC   2095580 . PMID   18042692.
  31. ↑ Yarchoan, Robert; Uldrick, Thomas S. (March 15, 2018). "HIV-Associated Cancers and Related Diseases". New England Journal of Medicine. Massachusetts Medical Society. 378 (11): 1029–1041. doi:10.1056/nejmra1615896. ISSN   0028-4793. PMC   6890231 . PMID   29539283.

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