Treatment of HIV-Associated Burkitt Lymphoma - European Medical Journal

Treatment of HIV-Associated Burkitt Lymphoma

Hematology
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Authors:
Giovanni Donadoni,1,2 Marta Bruno-Ventre,1,3 Andrés J. M. Ferreri1,2
Disclosure:

No potential conflict of interest.

Citation:
EMJ Hematol. ;1[1]:38-52. DOI/10.33590/emjhematol/10310781. https://doi.org/10.33590/emjhematol/10310781.
Keywords:
Burkitt lymphoma, AIDS, HIV, rituximab, chemoimmunotherapy, myc

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

Abstract

Burkitt lymphoma (BL) is a highly aggressive B-cell malignancy, occurring with increased frequency among patients infected with HIV. For several years, the immunocompromised state of HIV-positive patients was advocated as a sufficient reason to avoid the intensive chemotherapeutic regimens used in HIV-negative BL. However, with the introduction of the highly active antiretroviral therapy (HAART), the subsequent improvement of the immunological state of HIV-positive patients, and the disappointing results of less intensive schedules, investigators began to apply the same chemotherapeutic regimens used as a gold standard in HIV-negative non-Hodgkin lymphoma (NHL), including the use of rituximab. Despite promising results of different schedules in early-phase studies, agreement on the treatment of HIV-positive BL is still lacking, and further trials are needed to define a standard of care. Moreover, new treatment frontiers need to focus on improving the outcome for patients with advanced immunosuppression, unfavourable prognostic features- such as advanced stages and high International Prognostic Index (IPI) scores – and for those with adverse tumour biology.

This paper aims to revise the main epidemiological and physiopathological features of HIV-positive BL, to summarise the most relevant steps in the treatment of affected patients, and to elucidate the role of HAART in allowing HIV-positive patients to be managed with the therapeutic strategies currently used in HIV-negative patients with BL.

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