Treating HIV-Associated Lymphoma

People with HIV infections are at increased risk for lymphoma. Although people with HIV often have aggressive forms of lymphoma such as diffuse large B-cell lymphoma, primary CNS lymphoma, or Burkitt lymphoma, their outlook has improved a great deal in recent years. The use of highly active anti-retroviral therapy (HAART) to treat HIV has helped patients to better tolerate treatments such as chemo and immunotherapy.

The major problem in the past was that patients with HIV infection tended to have low blood cell counts to begin with, which made it hard to treat them with full doses of chemo. This problem has been relieved somewhat by the use of HAART and by the use of drugs to help the patient’s body make new blood cells. Still, doctors give chemo cautiously and monitor blood counts closely. HIV can lower the number of a certain white blood cell, the CD4 cell. Since, patients with low CD4 counts can have more problems when treated with rituximab, some experts omit this drug in patients who have low CD4 counts.

Most experts believe that the prognosis (outlook) for a person with HIV-associated lymphoma relates at least as much to the HIV infection as to the lymphoma. Modern anti-HIV therapy can often control the immune deficiency in patients with AIDS, so the outlook for those patients who develop lymphoma has improved. The treatment of the lymphoma itself depends on the specific type of lymphoma.

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Last Medical Review: August 26, 2014 Last Revised: February 29, 2016

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