Skip to main content

Advertisement

Springer Nature Link
Log in

HIV-related NK/T-cell lymphoma in the brain relapsed during intensive chemotherapy but regressed after chemotherapy discontinuation: the importance of maintaining cellular immunity

  • Case Report
  • Published:
International Journal of Hematology Aims and scope Submit manuscript

Abstract

This study reports a case of human immunodeficiency virus (HIV)-related natural killer/T-cell lymphoma with an unexpected clinical course. The lymphoma cells were positive for Epstein–Barr virus and the primary nodal lesions regressed after chemotherapy and combined antiretroviral therapy (c-ART); however, brain metastasis progressed along with a reduction in the CD8+ T-cell count. Chemotherapy was discontinued and the patient was treated with c-ART alone, resulting in regression of the brain lesions and recovery of the CD8+ T-cell count. This case highlights the importance of maintaining anti-tumor immunity in patients with HIV-related lymphoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Little RF, Gutierrez M, Jaffe ES, Pau A, Horne M, Wilson W. HIV-associated non-Hodgkin lymphoma: incidence, presentation, and prognosis. JAMA. 2001;285:1880–5.

    Article  PubMed  CAS  Google Scholar 

  2. Bohlius J, Schmidlin K, Costagliola D, Fatkenheuer G, May M, Caro-Murillo AM, et al. Incidence and risk factors of HIV-related non-Hodgkin’s lymphoma in the era of combination antiretroviral therapy: a European multicohort study. Antivir Ther. 2009;14:1065–74.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  3. Straus DJ. HIV-associated lymphomas. Curr Oncol Rep. 2001;3:260–5.

    Article  PubMed  CAS  Google Scholar 

  4. Antonino C. Emerging pathways in the development of AIDS-related lymphomas. Lancet Oncol. 2003;4:22–9.

    Article  Google Scholar 

  5. Camilleri-Broet S, Davi F, Feuillard J, Seilhean D, Michiels JF, Brousset P, et al. AIDS-related primary brain lymphomas: histopathologic and immunohistochemical study of 51 cases. The French study group for HIV-associated tumors. Hum Pathol. 1997;28:367–74.

    Article  PubMed  CAS  Google Scholar 

  6. Hamilton-Dutoit SJ, Raphael M, Audouin J, Diebold J, Lisse I, Pedersen C, et al. In situ demonstration of Epstein–Barr virus small RNAs (EBER 1) in acquired immunodeficiency syndrome-related lymphomas: correlation with tumor morphology and primary site. Blood. 1993;82:619–24.

    PubMed  CAS  Google Scholar 

  7. Audouin J, Diebold J, Pallesen G. Frequent expression of Epstein–Barr virus latent membrane protein-1 in tumour cells of Hodgkin’s disease in HIV-positive patients. J Pathol. 1992;167:381–4.

    Article  PubMed  CAS  Google Scholar 

  8. Spina F, Vaccher E, Nasti G, Tirelli U. Human immunodeficiency virus-associated Hodgkin’s disease. Semin Oncol. 2000;27:480–8.

    PubMed  CAS  Google Scholar 

  9. Castillo JJ, Beltran BE, Bibas M, Bower M, Collins JA, Cwynarski K, et al. Prognostic factors in patients with HIV-associated peripheral T-cell lymphoma: a multicenter study. Am J Hematol. 2011;86:256–61.

    Article  PubMed  Google Scholar 

  10. Gilardin L, Copie-Bergman C, Galicier L, Meignin V, Briere J, Timsit JF, et al. Peripheral T-cell lymphoma in HIV-infected patients: a study of 17 cases in the combination antiretroviral therapy era. Br J Haematol. 2013;161:843–51.

    Article  PubMed  CAS  Google Scholar 

  11. Canioni D, Arnulf B, Asso-Bonnet M, Raphael M, Brousse N. Nasal natural killer lymphoma associated with Epstein–Barr virus in a patient infected with human immunodeficiency virus. Arch Pathol Lab Med. 2001;125:660–2.

    PubMed  CAS  Google Scholar 

  12. Oh SC, Choi CW, Kim BS, Shin SW, Kim YH, Lee JS, et al. NK/T-cell lymphoma associated with Epstein–Barr virus in a patient infected with human immunodeficiency virus: an autopsy case. Int J Hematol. 2004;79:480–3.

    Article  PubMed  Google Scholar 

  13. Chim CS, Ma ES, Loong F, Kwong YL. Diagnostic cues for natural killer cell lymphoma: primary nodal presentation and the role of in situ hybridisation for Epstein–Barr virus encoded early small RNA in detecting occult bone marrow involvement. J Clin Pathol. 2005;58:443–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kagami Y, Suzuki R, Taji H, Yabe Y, Takeuchi T, Maeda S, et al. Nodal cytotoxic lymphoma spectrum: a clinicopathologic study of 66 patients. Am J Surg Pathol. 1999;23:1184–200.

    Article  PubMed  CAS  Google Scholar 

  15. Saffer H, Wahed A, Rassidakis GZ, Medeiros LJ. Clusterin expression in malignant lymphomas: a survey of 266 cases. Mod Pathol. 2002;15:1221–6.

    Article  PubMed  Google Scholar 

  16. Takahashi E, Asano N, Li C, Tanaka T, Shimada K, Shimada S, et al. Nodal T/NK-cell lymphoma of nasal type: a clinicopathological study of six cases. Histopathology. 2008;52:585–96.

    Article  PubMed  CAS  Google Scholar 

  17. Okamoto M, Maruyama F, Tsuzuki M, Nomura T, Miyazaki H, Wakita M, et al. Salvage chemotherapy for relapsed/refractory aggressive non-Hodgkin’s lymphoma with a combination of dexamethasone, etoposide, ifosfamide and carboplatin. Rinsho Ketsueki. 1994;35:635–41.

    PubMed  CAS  Google Scholar 

  18. Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, et al. Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol. 2009;27:5594–600.

    Article  PubMed  CAS  Google Scholar 

  19. Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, et al. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011;29:4410–6.

    Article  PubMed  CAS  Google Scholar 

  20. Yamaguchi M. Current and future management of NK/T-cell lymphoma based on clinical trials. Int J Hematol. 2012;96:562–71.

    Article  PubMed  Google Scholar 

  21. Sparano JA. Treatment of AIDS-related lymphomas. Curr Opin Oncol. 1995;7:442–9.

    Article  PubMed  CAS  Google Scholar 

  22. Barta SK, Xue X, Wang D, Tamari R, Lee JY, Mounier N. Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: a pooled analysis of 1546 patients. Blood. 2013;122:3251–62.

    Article  PubMed  CAS  Google Scholar 

  23. Starzl TE, Nalesnik MA, Porter KA, Ho M, Iwatsuki S, Griffith BP, et al. Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet. 1984;1:583–7.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  24. Webber S, Naftel D, Fricker F, Olesnevich P, Blume E, Addonizio L, et al. Lymphoproliferative disorders after paediatric heart transplantation: a multi-institutional study. Lancet. 2006;367:233–9.

    Article  PubMed  Google Scholar 

  25. Porcu P, Eisenbeis CF, Pelletier RP, Davies EA, Baiocchi RA, Roychowdhury S, et al. Successful treatment of posttransplantation lymphoproliferative disorder (PTLD) following renal allografting is associated with sustained CD8 + T-cell restoration. Blood. 2002;100:2341–8.

    Article  PubMed  CAS  Google Scholar 

  26. Pluda JM, Vemzon DJ, Tosato G, Lietzau J, Wyvill K, Nelson DL, et al. Parameters affecting the development of non-Hodgkin’s lymphoma in patients with severe human immunodeficiency virus infection receiving antiretroviral therapy. J Clin Oncol. 1993;11:1099–107.

    PubMed  CAS  Google Scholar 

  27. Tedeschi R, Bortolin MT, Bidoli E, Zanussi S, Pratesi C, Vaccher E, et al. Assessment of immunovirological features in HIV related non-Hodgkin lymphoma patients and their impact on outcome. J Clin Virol. 2012;53:297–301.

    Article  PubMed  Google Scholar 

  28. McGowan JP, Shah S. Long-term remission of AIDS-related primary central nervous system lymphoma associated with highly active antiretroviral therapy. AIDS. 1998;12:952–4.

    PubMed  CAS  Google Scholar 

  29. Corales R, Raege A. Regression of AIDS-related CNS lymphoma with HAART. XIII International AIDS Conference, Durban, 2000.

  30. Aboulafia DM, Puswella AL. Highly active antiretroviral therapy as the sole treatment for AIDS-related primary central nervous system lymphoma: a case report with implications for treatment. AIDS Patient Care STDS. 2007;21:900–7.

    Article  PubMed  Google Scholar 

  31. Teng YK, Schippers EF, Wijermans PW. Regression of HIV-associated grade IV T cell lymphoma with combined antiretroviral therapy only. Int J Hematol. 2011;93:811–4.

    Article  PubMed  CAS  Google Scholar 

  32. Travi G, Ferreri AJ, Cinque P, Gerevini S, Ponzoni M, Terreni MR, et al. Long-term remission of HIV-associated primary CNS lymphoma achieved with highly active antiretroviral therapy alone. J Clin Oncol. 2012;30:e119–21.

    Article  PubMed  Google Scholar 

  33. Choquet S, Leblond V, Herbrecht R, Socie G, Stoppa AM, Vandenberghe P, et al. Efficacy and safety of rituximab in B-cell post-transplantation lymphoproliferative disorders: results of a prospective multicenter phase 2 study. Blood. 2006;107:3053–7.

    Article  PubMed  CAS  Google Scholar 

  34. Swerdlow SH. T-cell and NK-cell posttransplantation lymphoproliferative disorders. Am J Clin Pathol. 2007;127:887–95.

    Article  PubMed  Google Scholar 

  35. Hoshida Y, Xu JX, Fujita S, Nakamichi I, Ikeda J, Tomita Y, et al. Lymphoproliferative disorders in rheumatoid arthritis: clinicopathological analysis of 76 cases in relation to methotrexate medication. J Rheumatol. 2007;34:322–31.

    PubMed  CAS  Google Scholar 

  36. Salloum E, Cooper DL, Howe G, Lacy J, Tallini G, Crouch J, et al. Spontaneous regression of lymphoproliferative disorders in patients treated with methotrexate for rheumatoid arthritis and other rheumatic diseases. J Clin Oncol. 1996;14:1943–9.

    PubMed  CAS  Google Scholar 

  37. Jones K, Nourse JP, Morrison L, Nguyen-Van D, Moss DJ, Burrows SR, et al. Expansion of EBNA1-specific effector T cells in posttransplantation lymphoproliferative disorders. Blood. 2010;116:2245–52.

    Article  PubMed  CAS  Google Scholar 

  38. Isobe Y, Aritaka N, Sasaki M, Oshimi K, Sugimoto K. Spontaneous regression of natural killer cell lymphoma. J Clin Pathol. 2009;62:647–50.

    Article  PubMed  CAS  Google Scholar 

  39. Bower M, Stebbing J, Tuthill M, Campbell V, Krell J, Holmes P, et al. Immunologic recovery in survivors following chemotherapy for AIDS-related non-Hodgkin lymphoma. Blood. 2008;111:3986–90.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1 Minami-Machi Minatojima, Chuo-Ku, Kobe, 650-047, Japan

    Yosuke Nagahata, Aiko Kato & Takayuki Ishikawa

  2. Department of Clinical Pathology, Kobe City Medical Center General Hospital, 2-1-1 Minami-Machi Minatojima, Chuo-Ku, Kobe, 650-047, Japan

    Yukihiro Imai

Authors
  1. Yosuke Nagahata
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Aiko Kato
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Yukihiro Imai
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Takayuki Ishikawa
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Yosuke Nagahata.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nagahata, Y., Kato, A., Imai, Y. et al. HIV-related NK/T-cell lymphoma in the brain relapsed during intensive chemotherapy but regressed after chemotherapy discontinuation: the importance of maintaining cellular immunity. Int J Hematol 100, 402–406 (2014). https://doi.org/10.1007/s12185-014-1610-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12185-014-1610-2

Keywords