EPIDEMOILOGY, DIAGNOSIS, AND TREATMENT OF HIV-ASSOCIATED NON-HODGKIN LYMPHPOMAS

Abstract

The objective of the study was to analyze clinical, immunological and morphological features of malignant non-Hodgkin lymphpomas (MNHL) in HIV-infected patients, evaluate the options and the results of the treatment for the patients in oncohematological hospital environment. Materials and methods. The study evaluated the data from Original Medical Records of 185 HIVinfected patients (mean age 36–40 years) with MNHL that was detected during the period from 1994 to 2017. The results of clinical, laboratory, morphological and immunohistochemical methods used for the study in HIV-infected patients with MNHL were represented. Results. During the period from 1994 to 2017, increasing in the number of HIV-infected patients with MNL, mean age of which was less than 40 years, had been marked. Duration of HIV-infection up to the time of detection the MNHL was 7 years but in 23% of cases the HIV-infection and tumor disease were diagnosed at the same time. Low number of CD4 lymphocyte cells (132 cells/μL) and high number of RNA HIV (more than 550 000 copies/μL) were detected in the blood of the patients. The following distribution was among morphological types of MNHL: diffuse large B-cell lymphoma (DLBCL) — 42%, Burkitt's lymphomas — 32%, plasmablastic lymphomas — 26%. Clinical lymphomas with the extranodal manifestations accompanied with large quantity of complications and opportunistic infections directly resulted from immunosuppression severity (p<0,05) were predominant (76%). Evaluation of combined chemoimmunotherapy effectiveness in HIV-infected patients and in the patients with MNHL showed comparable results in contrast with the population of seronegative HIV-infected patients under using standard polychemotherapy regimens with rituximab, antiretroviral therapy, prevention of infectious complications and immune reconstitution syndrome. Conclusion. Malignant non-Hodgkin lymphpomas represent the group of oncological diseases, which is predominant in HIV-infected patients. These diseases require team approach in early detection, current treatment, prevention of complications in the multidisciplinary team that will significantly improve disease outcome.