Abstract
Abstract The incidence of PCNSL is significantly increased in patients with either congenital or acquired immunodeficiencies. Infection with the human immunodeficiency virus (HIV) is one of the common causes of immunosuppression leading to PCNSL. PCNSL is diagnosed in patients with advanced HIV infection and extremely low CD4 counts, and therefore, there has been a dramatic decrease in its incidence in the highly active, anti-retroviral therapy (HAART) era. The prognosis of PCNSL in HIV patients in the pre-HAART era was dismal, leading some authorities to advocate a palliative approach. After the advent of HAART, the outcome of HIV-associated PCNSL (HIV-PCNSL) significantly improved in some series. However, in spite of the suggestion of a better outcome in more recent years, many (of the few) patients diagnosed with PCNSL in the HAART era are still managed in a palliative fashion. Thus, the prognosis of patients with HIV-PCNSL remains significantly worse than the prognosis of immunocompetent patients with PCNSL.
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References
Schabet M (1999) Epidemiology of primary CNS lymphoma. J Neurooncol 43:199–201
O’Neill BP, Vernino S, Dogan A et al (2007) EBV-associated lymphoproliferative disorder of CNS associated with the use of mycophenolate mofetil. Neurooncol 9:364–369
Kaufman DA, Hershfield MS, Bocchini JA et al (2005) Cerebral lymphoma in an adenosine deaminase-deficient patient with severe combined immunodeficiency receiving polyethylene glycol-conjugated adenosine deaminase. Pediatrics 116:e876–e879
Phan TG, O’Neill BP, Kurtin PJ (2000) Posttransplant primary CNS lymphoma. Neurooncol 2:229–238
Kleinschmidt-DeMasters BK, Damek DM, Lillehei KO et al (2008) Epstein Barr virus-associated primary CNS lymphomas in elderly patients on immunosuppressive medications. J Neuropathol Exp Neurol 67:1103–1111
Baeuerle M, Schmitt-Haendle M, Taubald A et al (2005) Severe HIV-1 encephalitis and development of cerebral non-Hodgkin lymphoma in a patient with persistent strong HIV-1 replication in the brain despite potent HAART – case report and review of the literature. Eur J Med Res 10:309–316
Ammassari A, Cingolani A, Pezzotti P et al (2000) AIDS-related focal brain lesions in the era of highly active antiretroviral therapy. Neurology 55:1194–1200
Besson C, Goubar A, Gabarre J et al (2001) Changes in AIDS-related lymphoma since the era of highly active antiretroviral therapy. Blood 98:2339–2344
Bower M, Powles T, Nelson M et al (2006) Highly active antiretroviral therapy and human immunodeficiency virus-associated primary cerebral lymphoma. J Natl Cancer Inst 98:1088–1091
Kreisl TN, Panageas KS, Elkin EB et al (2008) Treatment patterns and prognosis in patients with human immunodeficiency virus and primary central system lymphoma. Leuk Lymphoma 49:1710–1716
Robotin MC, Law MG, Milliken S et al (2004) Clinical features and predictors of survival of AIDS-related non-Hodgkin’s lymphoma in a population-based case series in Sydney, Australia. HIV Med 5:377–384
Cote TR, Manns A, Hardy CR et al (1996) Epidemiology of brain lymphoma among people with or without acquired immunodeficiency syndrome. AIDS/Cancer Study Group. J Natl Cancer Inst 88:675–679
Hoffmann C, Tabrizian S, Wolf E et al (2001) Survival of AIDS patients with primary central nervous system lymphoma is dramatically improved by HAART-induced immune recovery. AIDS 15:2119–2127
Skiest DJ, Crosby C (2003) Survival is prolonged by highly active antiretroviral therapy in AIDS patients with primary central nervous system lymphoma. AIDS 17:1787–1793
Newell ME, Hoy JF, Cooper SG et al (2004) Human immunodeficiency virus-related primary central nervous system lymphoma: factors influencing survival in 111 patients. Cancer 100:2627–2636
Haldorsen IS, Krakenes J, Goplen AK et al (2008) AIDS-related primary central nervous system lymphoma: a Norwegian national survey 1989-2003. BMC Cancer 8:225
Collaboration of Observational HIV Epidemiological Research Europe (COHERE) Study Group (2009) Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy. AIDS 23(15):2029–2037
Diamond C, Taylor TH, Aboumrad T et al (2006) Changes in acquired immunodeficiency syndrome-related non-Hodgkin lymphoma in the era of highly active antiretroviral therapy: incidence, presentation, treatment, and survival. Cancer 106:128–135
International Collaboration on HIV and Cancer (2000) Highly active antiretroviral therapy and incidence of cancer in human immunodeficiency virus-infected adults. J Natl Cancer Inst 92(22):1823–1830
Kirk O, Pedersen C, Cozzi-Lepri A et al (2001) Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy. Blood 98:3406–3412
Stebbing J, Gazzard B, Douek DC (2004) Where does HIV live? N Engl J Med 350:1872–1880
Larocca LM, Capello D, Rinelli A et al (1998) The molecular and phenotypic profile of primary central nervous system lymphoma identifies distinct categories of the disease and is consistent with histogenetic derivation from germinal center-related B cells. Blood 92:1011–1019
Montesinos-Rongen M, Kuppers R, Schluter D et al (1999) Primary central nervous system lymphomas are derived from germinal-center B cells and show a preferential usage of the V4-34 gene segment. Am J Pathol 155:2077–2086
Camilleri-Broet S, Criniere E, Broet P et al (2006) A uniform activated B-cell-like immunophenotype might explain the poor prognosis of primary central nervous system lymphomas: analysis of 83 cases. Blood 107:190–196
Carbone A, Gloghini A, Larocca LM et al (2001) Expression profile of MUM1/IRF4, BCL-6, and CD138/syndecan-1 defines novel histogenetic subsets of human immunodeficiency virus-related lymphomas. Blood 97:744–751
Camilleri-Broet S, Davi F, Feuillard J et al (1995) High expression of latent membrane protein 1 of Epstein-Barr virus and BCL-2 oncoprotein in acquired immunodeficiency syndrome-related primary brain lymphomas. Blood 86:432–435
Gasser O, Bihl FK, Wolbers M et al (2007) HIV patients developing primary CNS lymphoma lack EBV-specific CD4+ T cell function irrespective of absolute CD4+ T cell counts. PLoS Med 4:e96
Camilleri-Broet S, Camparo P, Mokhtari K et al (2000) Overexpression of BCL-2, BCL-X, and BAX in primary central nervous system lymphomas that occur in immunosuppressed patients. Mod Pathol 13:158–165
Camilleri-Broet S, Davi F, Feuillard J et al (1997) AIDS-related primary brain lymphomas: histopathologic and immunohistochemical study of 51 cases. The French Study Group for HIV-Associated Tumors. Hum Pathol 28:367–374
Goldstein JD, Dickson DW, Moser FG et al (1991) Primary central nervous system lymphoma in acquired immune deficiency syndrome. A clinical and pathologic study with results of treatment with radiation. Cancer 67:2756–2765
Ling SM, Roach M 3rd, Larson DA et al (1994) Radiotherapy of primary central nervous system lymphoma in patients with and without human immunodeficiency virus. Ten years of treatment experience at the University of California San Francisco. Cancer 73:2570–2582
Forsyth PA, Yahalom J, DeAngelis LM (1994) Combined-modality therapy in the treatment of primary central nervous system lymphoma in AIDS. Neurology 44:1473–1479
Batchelor T, Loeffler JS (2006) Primary CNS lymphoma. J Clin Oncol 24:1281–1288
Fine HA, Mayer RJ (1993) Primary central nervous system lymphoma. Ann Intern Med 119:1093–1104
Jacomet C, Girard PM, Lebrette MG et al (1997) Intravenous methotrexate for primary central nervous system non-Hodgkin’s lymphoma in AIDS. AIDS 11:1725–1730
Miller RF, Hall-Craggs MA, Costa DC et al (1998) Magnetic resonance imaging, thallium-201 SPET scanning, and laboratory analyses for discrimination of cerebral lymphoma and toxoplasmosis in AIDS. Sex Transm Infect 74:258–264
Ferreri AJ, Blay JY, Reni M et al (2003) Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience. J Clin Oncol 21:266–272
Hoffman JM, Waskin HA, Schifter T et al (1993) FDG-PET in differentiating lymphoma from nonmalignant central nervous system lesions in patients with AIDS. J Nucl Med 34:567–575
O’Doherty MJ, Barrington SF, Campbell M et al (1997) PET scanning and the human immunodeficiency virus-positive patient. J Nucl Med 38:1575–1583
De Luca A, Antinori A, Cingolani A et al (1995) Evaluation of cerebrospinal fluid EBV-DNA and IL-10 as markers for in vivo diagnosis of AIDS-related primary central nervous system lymphoma. Br J Haematol 90:844–849
Cingolani A, De Luca A, Larocca LM et al (1998) Minimally invasive diagnosis of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. J Natl Cancer Inst 90:364–369
Antinori A, De Rossi G, Ammassari A et al (1999) Value of combined approach with thallium-201 single-photon emission computed tomography and Epstein-Barr virus DNA polymerase chain reaction in CSF for the diagnosis of AIDS-related primary CNS lymphoma. J Clin Oncol 17:554–560
Giancola ML, Rizzi EB, Schiavo R et al (2004) Reduced value of thallium-201 single-photon emission computed tomography in the management of HIV-related focal brain lesions in the era of highly active antiretroviral therapy. AIDS Res Hum Retroviruses 20:584–588
Ivers LC, Kim AY, Sax PE (2004) Predictive value of polymerase chain reaction of cerebrospinal fluid for detection of Epstein-Barr virus to establish the diagnosis of HIV-related primary central nervous system lymphoma. Clin Infect Dis 38:1629–1632
Wang J, Ozzard A, Nathan M et al (2007) The significance of Epstein-Barr virus detected in the cerebrospinal fluid of people with HIV infection. HIV Med 8:306–311
Corcoran C, Rebe K, van der Plas H et al (2008) The predictive value of cerebrospinal fluid Epstein-Barr viral load as a marker of primary central nervous system lymphoma in HIV-infected persons. J Clin Virol 42:433–436
Bower M, Collins S, Cottrill C et al (2008) British HIV Association guidelines for HIV-associated malignancies 2008. HIV Med 9:336–388
Abrey LE, Batchelor TT, Ferreri AJ et al (2005) Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma. J Clin Oncol 23:5034–5043
Bower M, Fife K, Sullivan A et al (1999) Treatment outcome in presumed and confirmed AIDS-related primary cerebral lymphoma. Eur J Cancer 35:601–604
Chamberlain MC (1994) Long survival in patients with acquired immune deficiency syndrome-related primary central nervous system lymphoma. Cancer 73:1728–1730
Weinberg A, Li S, Palmer M et al (2002) Quantitative CSF PCR in Epstein-Barr virus infections of the central nervous system. Ann Neurol 52:543–548
Raez L, Cabral L, Cai JP et al (1999) Treatment of AIDS-related primary central nervous system lymphoma with zidovudine, ganciclovir, and interleukin 2. AIDS Res Hum Retroviruses 15:713–719
Aboulafia DM, Ratner L, Miles SA et al (2006) Antiviral and immunomodulatory treatment for AIDS-related primary central nervous system lymphoma: AIDS Malignancies Consortium pilot study 019. Clin Lymphoma Myeloma 6:399–402
Bossolasco S, Falk KI, Ponzoni M et al (2006) Ganciclovir is associated with low or undetectable Epstein-Barr virus DNA load in cerebrospinal fluid of patients with HIV-related primary central nervous system lymphoma. Clin Infect Dis 42:e21–e25
Diamond C, Taylor TH, Im T et al (2006) Highly active antiretroviral therapy is associated with improved survival among patients with AIDS-related primary central nervous system non-Hodgkin’s lymphoma. Curr HIV Res 4:375–378
Aboulafia DM, Puswella AL (2007) 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 21:900–907
Lin CH, Kuo KT, Chuang SS et al (2006) Comparison of the expression and prognostic significance of differentiation markers between diffuse large B-cell lymphoma of central nervous system origin and peripheral nodal origin. Clin Cancer Res 12:1152–1156
Acknowledgment
The author would like to thank Professor TA Lister for his helpful comments on the chapter. Silvia Montoto was kindly supported by grants from the Olivia Walduck family and the Ridgwell family.
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Montoto, S. (2012). CNS Lymphoma in the Immunocompromised Host. In: Batchelor, T., DeAngelis, L. (eds) Lymphoma and Leukemia of the Nervous System. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7668-0_10
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