Anti-CD20 monoclonal antibody treatment of human herpesvirus 8-associated, body cavity-based lymphoma with an unusual phenotype in a human immunodeficiency virus-negative patient

Fil: Pérez, Celeste L. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Virología; Argentina.Fil: Rudoy, Silvia. Hospital Santojanni. Servicio de Hematología; Argentina.Human herpesvirus 8 (HHV-8), or Kaposi's sarcoma-associated herpesvirus, is a gammaherpesvirus first detected in Kaposi's sarcoma tumor cells and subsequently in primary effusion lymphoma (PEL) tumor cells and peripheral blood mononuclear cells from PEL patients. PEL has been recognized as an individual nosologic entity based on its distinctive features and consistent association with HHV-8 infection. PEL is an unusual form of body cavity-based B-cell lymphoma (BCBL). It occurs predominantly in human immunodeficiency virus (HIV)-positive patients but occasionally also in elderly HIV-negative patients. We describe a case of PEL, with ascites, bilateral pleural effusions, and a small axillary lymphadenopathy, in a 72-year-old HIV-negative man. PCR performed on a lymph node specimen and in liquid effusion was positive for HHV-8 and negative for Epstein-Barr virus. The immunophenotype of the neoplastic cells was B CD19+ CD20+ CD22+ with coexpression of CD10 and CD23 and with clonal kappa light chain rearrangement. The patient was treated with Rituximab, a chimeric (human-mouse) anti-CD20 monoclonal antibody. Thirteen months later, the patient continued in clinical remission. This is the first report of an HHV-8-associated BCBL in an HIV-negative patient in Argentina

Anti-CD20 monoclonal antibody treatment of human herpesvirus 8-associated, body cavity-based lymphoma with an unusual phenotype in a human immunodeficiency virus-negative patient

Fil: Pérez, Celeste L. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Virología; Argentina.Fil: Rudoy, Silvia. Hospital Santojanni. Servicio de Hematología; Argentina.Human herpesvirus 8 (HHV-8), or Kaposi's sarcoma-associated herpesvirus, is a gammaherpesvirus first detected in Kaposi's sarcoma tumor cells and subsequently in primary effusion lymphoma (PEL) tumor cells and peripheral blood mononuclear cells from PEL patients. PEL has been recognized as an individual nosologic entity based on its distinctive features and consistent association with HHV-8 infection. PEL is an unusual form of body cavity-based B-cell lymphoma (BCBL). It occurs predominantly in human immunodeficiency virus (HIV)-positive patients but occasionally also in elderly HIV-negative patients. We describe a case of PEL, with ascites, bilateral pleural effusions, and a small axillary lymphadenopathy, in a 72-year-old HIV-negative man. PCR performed on a lymph node specimen and in liquid effusion was positive for HHV-8 and negative for Epstein-Barr virus. The immunophenotype of the neoplastic cells was B CD19+ CD20+ CD22+ with coexpression of CD10 and CD23 and with clonal kappa light chain rearrangement. The patient was treated with Rituximab, a chimeric (human-mouse) anti-CD20 monoclonal antibody. Thirteen months later, the patient continued in clinical remission. This is the first report of an HHV-8-associated BCBL in an HIV-negative patient in Argentina

PET-adapted therapy after three cycles of ABVD for all stages of Hodgkin lymphoma: results of the GATLA LH-05 trial

The role of Ann Arbor staging in determining treatment intensity after achieving a negative positron emission tomography (PET) has not been established in classical Hodgkin lymphoma (cHL). Patients with stage I–IV cHL, received three cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) and an interim PET scan (PET3). PET3-negative patients received no further therapy. PET3-positive patients received three additional cycles of ABVD plus involved-field radiation therapy or salvage chemotherapy, if refractory to ABVD, and were re-evaluated by PET scan (PET6). Study endpoints were 3-year progression-free survival (PFS) and overall survival (OS) rates. Two hundred and thirty-nine patients with early-stage and 138 with advanced-stage were evaluable. Overall, 260 patients (70%) were PET3-negative and had higher 3-year PFS (90% vs. 65%; P < 0 0001) and OS (98% vs. 92%; P = 0 007) rates than PET3-positive patients. All PET3-negative patients, regardless of disease stage at diagnosis, achieved similarly good PFS (90–91%; P = 0 76) and OS (97–99%). The only independent prognostic factor for PFS was PET3-negativity (Hazard ratio 3 8; 95% confidence interval 2 4–6 3; P < 0 0001). This study suggests that cHL patients who achieve a negative PET3 following ABVD have an excellent outcome, regardless of stage at diagnosis. An appropriately powered, phase III trial will be necessary to confirm these findings.Fil: Pavlovsky, Astrid. Fundación Para Combatir la Leucemia; Argentina. Centro de Hematología Pavlovsky; ArgentinaFil: Fernández, Isolda. Fundación Para Combatir la Leucemia; Argentina. Centro de Hematología Pavlovsky; ArgentinaFil: Kurgansky, Nicolas. Doctus; ArgentinaFil: Prates, Virginia. Hospital Italiano de La Plata; ArgentinaFil: Zoppegno, Lucia. Hospital General San Martín; ArgentinaFil: Negri, Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Privado de Hematología y Hemoterapia; ArgentinaFil: Milone, Gustavo. Fundación Para Combatir la Leucemia; ArgentinaFil: Cerutti, Ider. Idhea Clinica Hematologica Dr Cerutti Ider; ArgentinaFil: Zabaljauregui, Soledad. Academia Nacional de Medicina de Buenos Aires; ArgentinaFil: Mariano, Romina. Provincia de Entre Rios. Hospital San Martin; ArgentinaFil: Grecco, Horacio F.. Sanatorio Dr. Julio Méndez; ArgentinaFil: Basquiera, Ana Lisa. Hospital Privado Universitario de Cordoba.; ArgentinaFil: Saba, Silvia. Hospital Rodolfo Rossi; ArgentinaFil: Rudoy, Silvia. Clínica Modelo de Morón; ArgentinaFil: Sackmann, Federico. Fundación Para Combatir la Leucemia; ArgentinaFil: Castano, Vanesa. Idhea Clinica Hematologica Dr Cerutti Ider; ArgentinaFil: Remaggi, Guillermina. Fundación Para Combatir la Leucemia; ArgentinaFil: Cabrejo, María del Rosario. Sanatorio Dr. Julio Méndez; ArgentinaFil: Roveri, Eriberto. Idhea Clinica Hematologica Dr Cerutti Ider; ArgentinaFil: Casale, María Florencia. Instituto Privado de Hematología y Hemoterapia; Argentina. Hospital General Centeno; ArgentinaFil: Cabane, Vanina. Clínica Dr. Roberto Raña; ArgentinaFil: Taus, Rossana. Hospital Rodolfo Rossi; ArgentinaFil: Venturini, Claudia. Instituto Privado de Hematología y Hemoterapia; ArgentinaFil: Sakamoto, Francisco. Instituto Privado de Hematología y Hemoterapia; ArgentinaFil: Varela, Ana I.. Sanatorio Las Lomas Sociedad Anonima.; ArgentinaFil: Riddick, Maximiliano Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Matemáticas; ArgentinaFil: Pavlovsky, Santiago. Fundación Para Combatir la Leucemia; Argentin