(AIDS)-related lymphoma (ARL)

Acquired immunodeficiency syndrome (AIDS)-related lymphoma (ARL)

Risk of developing AIDS related lymphoma within 3 years of the diagnosis of AIDS is 165 times that of others without AIDS.

Increased risk 652 fold for high grade diffuse immunoblastic lymphoma.

261 fold increase risk for the development of Burkitt’s lymphoma.

113 fold increase of intermediate-grade lymphoma.

14 fold increase in the risk of developing low grade lymphomas.

8-10 fold increase in the risk of developing Hodgkin’s disease.

With the introduction of HAART there has been a reduction in the incidence of AIDS related lymphoma (non-Hodgkin’s) but not in Hodgkin’s disease.

Following the introduction of HAART the incidence of primary cerebral lymphoma has fallen significantly associated a result of improvement of immune status.

Uncommon entities such as plasmablastic or primary effusion lymphoma are AIDS related lymphomas.

Possible explanation for the development of heterogeneous group of lymphomas include chronic B cell stimulation by HIV and co-infecting viruses such as Epstein-Barr and human herpes virus 8, which can result in deregulated cytokine production and genetic mutations leading the malignant transformation.

Outcome for treatment of diffuse large B cell lymphoma comparable to that of the same lesion seen without AIDS.

Absolutely with combination antiretroviral therapy the overall risk of lymphoma has decreased.

Lymphoma continues to be the leading cause of cancer related death among patients with HIV infection in the era of combination antiretroviral therapy.

US Centers for AIDS research Network data on 23050 patients with HIV infection diagnosed between 1996 and 2011 revealed lymphomas developed in 2.1% of these patients, most of which were diffuse large b-cell lymphoma – 42.2%, followed by Hodgkin’s lymphoma 16.6%, Burkitt lymphoma 11.8% primary CNS lymphoma 11.3% and other non-hodgkin lymphomas 18.1%.

Pre-HAART median survival of approximately 6 months for AIDS related Burkitt’s lymphoma has not improved with HAART agents.

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