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 Blood, 5 February 2009, Vol. 113, No. 6, pp. 1213-1224.
Prepublished online as a Blood First Edition Paper on October 27, 2008; DOI 10.1182/blood-2008-09-180315.

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REVIEW ARTICLE

HIV-associated lymphomas and gamma-herpesviruses

Antonino Carbone1, Ethel Cesarman2, Michele Spina3, Annunziata Gloghini1, and Thomas F. Schulz4

1 Department of Pathology, National Cancer Institute of Milan, Milan, Italy; 2 Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY; 3 Division of Medical Oncology A, Centro di Riferimento Oncologico, Aviano, Italy; and 4 Department of Virology, Hannover Medical School, Hannover, Germany

Among the most common HIV-associated lymphomas are Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) with immunoblastic-plasmacytoid differentiation (also involving the central nervous system). Lymphomas occurring specifically in HIV-positive patients include primary effusion lymphoma (PEL) and its solid variants, plasmablastic lymphoma of the oral cavity type and large B-cell lymphoma arising in Kaposi sarcoma herpesvirus (KSHV)–associated multicentric Castleman disease. These lymphomas together with BL and DLBCL with immunoblastic-plasmacytoid differentiation frequently carry EBV infection and display a phenotype related to plasma cells. EBV infection occurs at different rates in different lymphoma types, whereas KSHV is specifically associated with PEL, which usually occurs in the setting of profound immunosuppression. The current knowledge about HIV-associated lymphomas can be summarized in the following key points: (1) lymphomas specifically occurring in patients with HIV infection are closely linked to other viral diseases; (2) AIDS lymphomas fall in a spectrum of B-cell differentiation where those associated with EBV or KSHV commonly exhibit plasmablastic differentiation; and (3) prognosis for patients with lymphomas and concomitant HIV infection could be improved using better combined chemotherapy protocols in-corporating anticancer treatments and antiretroviral drugs.


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