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AIDS-related Lymphoma

(HIV-Associated Lymphoma, AIDS-Related Non-Hodgkins Lymphoma)

Definition

Lymphomas are cancers of the lymph system. The lymph system is a series of nodes, channels, and tissue throughout the body. There are different types of lymphomas.

AIDS-related lymphoma develops in people with HIV. It is one of the complications that show that AIDS has developed.

AIDS-related lymphoma is a type of non-Hodgkin lymphoma (NHL). NHL can be more aggressive in people with AIDS.

The Lymphatic System

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Causes

NHL starts because of DNA damage in a new white blood cell. The damaged cell divides and grows in an abnormal way. This in turn creates more damaged cells. The cells can form a tumor and invade nearby tissue. The cancer can also spread to other areas of your body. It is not clear what causes the change to DNA. It may be a combination of genetics and factors in your environment.

Risk Factors

Having HIV infection increases the risk of AIDS-related primary CNS lymphoma.

HIV damages the white blood cells in the body. The body will need to make more white blood cells to replace the damaged cells. This increases the chance that a white blood cell with damaged DNA can develop.

HIV also lowers the immune system. This makes people more vulnerable to cancer in general.

Symptoms

Lymph tissue is spread across the body. The cancer may start anywhere in the lymph. The location of cancer will affect the symptoms. Some more general examples include:

  • Swelling in the neck, chest, underarm, or groin
  • Unexpected weight loss
  • Fever
  • Night sweats
  • Fatigue
  • Itchy skin

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done.

Signs of lymphoma may be found in body fluids and tissue. Tests may include:

Any area of suspicious tissue will need to be tested. A small sample of tissue will be removed and examined in a lab for cancer cells. Tissue samples may be removed during:

Images may be taken to see where cancer is. It may also show how much tissue is involved. Tests may include:

Tests will be used to find the stage of cancer. Staging is based on how far the cancer has spread and what body parts are affected. Staging will help with the treatment plan.

Treatment

Treatment depends on the type and stage of the cancer. Your care plan will also depend on how aggressive your cancer is. Treatment for HIV infection will start or continue as well.

Cancer treatments can weaken the immune system even more. It is important to manage the HIV infection and keep the immune system as strong as possible. Treatment for HIV includes highly active antiretroviral therapy (HAART). These medicines can improve the immune system. Chemotherapy medicine can interfere with some AIDS medicine. Your care team may need to adjust medicine during treatment.

Treatment for the lymphoma may include:

Chemotherapy

Chemotherapy (Chemo) can affect cells all over the body. This makes it a common choice of treatment for lymphoma. Chemo uses drugs to kill cancer cells. It may be passed into the blood stream or straight into the fluid around the brain (intrathecal). While chemo is focused on killing cancer cells, some healthy cells are affected as well. This can cause a range of side effects. It is often given over a number of cycles. Each cycle may include a few weeks of rest after a few days of treatment.

Steroid medicine may also be given with either therapy. It may make the therapy more effective. This medicine may also decrease some of the side effects of chemo.

Monoclonal Antibody Therapy

Antibodies are an important part of the immune system. They signal which items in the body need to be attacked by the immune system. Monoclonal antibody drugs are made to signal cancer cells for attack. They will stick to the surface of cancer cells. The immune system will then know to attack them.

Radiation Therapy

Radiation therapy is the delivery of high energy to a set area. This energy disrupts the DNA in the cancer cells. It will stop theses cells from growing and making more cancer cells. Radiation therapy may also help shrink tumor size. This may help to relieve symptoms caused by larger growths. It may be given alone or in combination with chemo.

Prevention

There are no specific steps to prevent this type of cancer. Follow your HIV or AIDS care plan. It may help to keep the immune system strong and decrease the risk of certain cancers.

RESOURCES:

Centers for Disease Control and Prevention
https://www.cdc.gov

National Cancer Institute
https://www.cancer.gov

CANADIAN RESOURCES:

ACT—AIDS Committee of Toronto
www.actoronto.org

Canadian AIDS Society
http://www.cdnaids.ca

REFERENCES:

AIDS-related lymphoma treatment (PDQ)—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/lymphoma/patient/aids-related-treatment-pdq. Updated October 12, 2016. Accessed March 29, 2018.

HIV-related lymphoma. Macmillan Cancer Support website. Available at: https://www.macmillan.org.uk/information-and-support/lymphoma/lymphoma-non-hodgkin/types-of-non-hodgkin-lymphoma/hiv-related-lymphoma.html. Accessed March 29, 2018.

Overview of HIV infection. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114424/Overview-of-HIV-infection. Updated March 5, 2018. Accessed March 29, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 12/13/2018