Lymphomas in immunocompromised host (Meeting abstract).

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Lymphomas in immunocompromised host (Meeting abstract).

Eighth Mediterranean Congress of Chemotherapy. May 24-29, 1992, Athens, Greece, p. 621, 1992.. Unique Identifier : AIDSLINE ICDB/93688733
Pangalis GA; Boussiotis VA; First Dept. of Medicine, Univ. of Athens Sch. of Medicine,; Athens, Greece

Abstract: Immunocompromised host population consisted of patients (pts) with primary congenital immunodeficiencies and the recently evolving group of immunocompromised pts: allograft recipients, malignant disease survivors receiving antineoplastic drug therapy, and pts with autoimmune diseases (AD) or acquired immune deficiency syndrome (AIDS). It is now known that among them, there is a high incidence of malignancies, predominantly lymphoid (secondary lymphomas [SL]). Characteristics of SLs that distinguish them from the de novo arising lymphomas are of multiclonal or B-cell origin, frequently lack immunologic characteristics, are of extranodal and uncommon localization (CNS, liver, bowel) and have unfavorable prognosis. SLs of primary immunodeficiencies are 50-60% non-Hodgkin's (NHL), 15-25% Hodgkin's (HD) and 10-15% unclassified. Incidence of SL in renal transplant recipients is 30-50 times that of the general population, while cardiac transplant recipients are at lower risk; these mainly affect pts receiving cyclosporin A. To the contrary, SLs are very rare after bone marrow transplantation and almost uniquely observed in recipients of T-cell-depleted marrow from mismatched donors who also received a-CD3 monoclonal antibody treatment with GVHD. SLs arising in AD (rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, autoimmune thyroiditis, angioimmunoblastic lymphadenopathy) can be associated both with nature of disease and therapy and are predominantly immunoblastic. SLs have been observed after radiotherapy and long-term chemotherapy for primary neoplasms (breast cancer, acute lymphoblastic leukemia) and also following lymphocytic predominance HD in all therapy groups even after irradiation alone, indicating an association with the nature of disease rather than type of therapy. Multiple cellular copies of the EBV genome have been detected by DNA hybridization in the majority of cases with SL. Whether this finding is of etiologic significance or is the result of failure of normal immune response is yet unknown. SLs in AIDS are mainly high-grade NHL (immunoblastic and Burkitt's type) but are also HD observed almost exclusively in AIDS with persistent generalized lymphadenopathy. In conclusion, SLs arising in immunocompromised hosts consist of a distinct group of lymphomas. Further studies on immunoglobulin and T-cell-receptor gene rearrangements, karyotype abnormalities, oncogene activation and viral sequence identification are necessary to elucidate the pathogenesis and nature of this unique category of lymphoproliferative diseases.

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS Autoimmune Diseases/COMPLICATIONS Bone Marrow Transplantation Breast Neoplasms/COMPLICATIONS/IMMUNOLOGY Chromosome Abnormalities Gene Rearrangement Hodgkin's Disease/COMPLICATIONS/IMMUNOLOGY Human *Immunocompromised Host Karyotyping Kidney Transplantation Leukemia, Lymphocytic, Acute/COMPLICATIONS/IMMUNOLOGY Lymphocyte Depletion Lymphoma/COMPLICATIONS/GENETICS/*IMMUNOLOGY/THERAPY Lymphoma, B-Cell/COMPLICATIONS/IMMUNOLOGY Lymphoma, Non-Hodgkin's/COMPLICATIONS/IMMUNOLOGY Receptors, Antigen, T-Cell/GENETICS T-Lymphocytes ABSTRACT
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M9331097

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