05 June 2015 : Case report
Spontaneous Regression of Refractory Diffuse Large B-Cell Lymphoma with Improvement in Immune Status with ART in a Patient with HIV: A Case Report and Literature Review
Unusual clinical course, Unusual or unexpected effect of treatment, Unexpected drug reactionBirendra K.C.ABCDEFG, Muhammad Zubair AfzalBCEF, Katherine A. WentlandBC, Hamza HashmiE, Sudhir SinghEF, Elena IvanE, Nehal LakhaniACD
Am J Case Rep 2015; 16:347-352
BACKGROUND: Diffuse large B-cell lymphoma accounts for the large majority of AIDS-related non-Hodgkin lymphoma. Traditionally, this lymphoma has been treated with CHOP-like regimens with the recent addition of rituximab. We report a unique case where an HIV-infected patient with diffuse large B-cell lymphoma had complete regression of the lymphoma with continued antiretroviral therapy (ART) after chemotherapy was stopped.
CASE REPORT: A 55-year-old man who presented with fatigue and weight loss had initial CT findings of bilateral renal masses during his workup. Biopsy revealed diffuse large B-cell lymphoma and subsequently he was also diagnosed with HIV. He completed 6 cycles of CHOP-like (4 cycles of EPOCH-R and 2 cycles of R-CHOP) first-line therapy with significant dose delays and dose reductions due to severe adverse effects. Chemotherapy was stopped due to physical deconditioning and intolerable adverse effects. He had a FDG-PET/CT showing progression of his disease 8 weeks after completing chemotherapy. He was maintained only on ART after finishing 6 cycles of chemotherapy. With this therapy alone and with improvement in his immune status, his lymphoma regressed completely.
CONCLUSIONS: There are very few reported cases in which lymphoma has regressed with treatment of HIV alone, as is regression of diffuse large B-cell lymphoma. This case emphasizes that ART can lead to immune reconstitution of HIV-infected patients and can establish the anti-tumor effect, causing regression of the lymphoma.
Keywords: HIV Infections - complications, HIV, Biopsy, Immunity, Innate, Lymphoma, Large B-Cell, Diffuse - immunology, Remission, Spontaneous, Tomography, X-Ray Computed
26 Jan 2023 : Case reportA 39-Year-Old Woman with Endometriosis Who Developed a Subcapsular Liver Hematoma Following Laparotomic Sur...
Am J Case Rep In Press; DOI: 10.12659/AJCR.938169
26 Jan 2023 : Case reportOptic Neuritis as a Consequence of Long-Term Medical Treatment Using Anastrozole: A Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.939026
26 Jan 2023 : Case reportA Rare Case of Ruptured Appendicitis Secondary to Metastatic Ovarian Cancer
Am J Case Rep In Press; DOI: 10.12659/AJCR.938982
Most Viewed Current Articles
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406
23 Feb 2022 : Case reportPenile Necrosis Associated with Local Intravenous Injection of Cocaine
Am J Case Rep 2022; 23:e935250