Outcomes in Kaposi's sarcoma-associated herpesvirus -associated primary effusion lymphoma and multicentric Castleman's disease in patients with human immunodeficiency virus (HIV) in a safety-net hospital system

Eur J Haematol. 2024 May;112(5):723-730. doi: 10.1111/ejh.14163. Epub 2023 Dec 28.

Abstract

Objective: To describe cases of Kaposi's sarcoma-associated herpesvirus (KSHV)-associated multicentric Castleman's disease (MCD) and primary effusion lymphoma (PEL) in patients with HIV from a large, safety-net hospital system in Dallas, Texas, USA.

Methods: We conducted a retrospective review of patients with HIV-associated PEL and/or MCD.

Results: Twelve patients with PEL and 10 patients with MCD were identified. All patients were male and 17 of 20 were men who have sex with men; 66.7% of PEL patients and 50% of MCD patients had concurrent KS at the time of diagnosis; 42% of patients with PEL and 20% of patients with MCD died during the follow-up period. We noted improved survival in our cohort compared to previous studies, particularly in our PEL patients with a median survival of 11.4 months compared to 3-6-month median survival historically. Median follow-up time for MCD patients was 17.5 months. This improved survival is despite suboptimal antiretroviral therapy (ART) adherence at diagnosis, with only 50% of patients on ART at the time of MCD/PEL diagnosis.

Conclusion: These data highlight the importance of early recognition of PEL and MCD, and the larger-scale efforts needed to better understand the pathogenetic drivers of clinical outcomes in patients affected by KSHV-related diseases.

Keywords: Castleman's disease; HIV; human herpesvirus‐8; primary effusion lymphoma.

MeSH terms

  • Castleman Disease* / complications
  • Castleman Disease* / diagnosis
  • Female
  • HIV
  • HIV Infections* / complications
  • Herpesvirus 8, Human*
  • Homosexuality, Male
  • Humans
  • Lymphoma, Primary Effusion* / diagnosis
  • Lymphoma, Primary Effusion* / epidemiology
  • Lymphoma, Primary Effusion* / etiology
  • Male
  • Safety-net Providers
  • Sarcoma, Kaposi* / complications
  • Sarcoma, Kaposi* / diagnosis
  • Sarcoma, Kaposi* / epidemiology
  • Sexual and Gender Minorities*

Supplementary concepts

  • Multi-centric Castleman's Disease