Treating HIV-Associated Lymphoma

People with HIV infections are at increased risk for non-Hodgkin lymphoma. Although people with HIV tend to get more 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.

A 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 white blood cells known as CD4-positive cells. People with low CD4 counts can have more problems when treated with rituximab, so some experts don’t use this drug for 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 patients who develop lymphoma has improved.

The treatment of the lymphoma itself depends on the specific type of lymphoma.

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Freedman AS, Jacobson CA, Mauch P, Aster JC. Chapter 103: Non-Hodgkin’s lymphoma. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.

National Cancer Institute. Physician Data Query (PDQ). Adult Non-Hodgkin Lymphoma Treatment. 2016. Accessed at www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq on May 15, 2016.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Non-Hodgkin’s Lymphomas. Version 3.2016. Accessed at www.nccn.org/professionals/physician_gls/pdf/nhl.pdf on May 11, 2016.

Roschewski MJ, Wilson WH. Chapter 106: Non-Hodgkin Lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier; 2014.

Last Medical Review: May 31, 2016 Last Revised: May 31, 2016

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