HIV-infection in stagewith secondary disease

Plasma cell neoplasms in HIV-Infected Patients: A Literature Review and Case Series

LYMPHOID TUMORS , ,

RA Leigton2, AV Pivnik1, EP Sergeeva1, NV Kremneva1, OV Mukhin1

1AS Loginov Moscow Clinical Scientific Center, 86 Entuziastov sh., Moscow, Russian Federation, 111123

2Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya str., Moscow, Russian Federation, 117198

For correspondence: Prof. Aleksandr Vasil’evich Pivnik, MD, PhD, 86 Entuziastov sh., Moscow, Russian Federation, 111123; Tel.: 8(495)304-30-39; e-mail: pivnikav@gmail.com

For citation: Leigton RA, Pivnik AV, Sergeeva EP, et al. Plasma cell neoplasms in HIV-Infected Patients: A Literature Review and Case Series. Clinical oncohematology. 2017;10(4):464–70 (In Russ).

DOI: 10.21320/2500-2139-2017-10-4-464-470

ABSTRACT

Aim. Analysis of 37 published and 2 author’s cases of multiple myeloma (MM) in HIV-positive patients.

Materials & Methods. Description of 37 patients and 2 author’s previously unpublished observations.

Results. The median age of patients was 37 years (66 in the general population), only 2 % being under 40 years. Abnormal MM progression was observed including the emergence of extramedullary lesions, low levels of M-gradient, and the development of plasmoblastic leukemia. Historically, before highly active antiretroviral therapy (HAART) was introduced, a rapid progression of MM with a short life expectancy was observed. HAART in combination with chemotherapy showed the best results of MM treatment in terms of overall and relapse-free survival. According to the literature data HAART may also be used to treat HIV-negative patients with MM. The cytological analysis of MM showed atypical myeloma cells with no lysozyme, leukocyte common antigen, CD19, and CD20. The CD38 was clearly identified. Anaplastic MM may be regarded as the first manifestation of AIDS. The author’s results were similar to the published data.

Conclusion. MM in HIV-infected patients in stage with secondary diseases is still considered to be not HIV-related. In HIV-positive MM patients on HAART overall and relapse-free survival rates were higher than that in HIV-negative patients with MM. The serum levels M-gradient was shown to decrease or even become indeterminate in MM patients receiving HAART for HIV infection. Thus, the HAART was proposed for MM HIV-negative patients.

Keywords: plasma cell neoplasms, HIV-infection in stage with secondary disease, HAART.

Received: April 7, 2017

Accepted: July 6, 2017

Read in PDF

REFERENCES

  1. Покровский В.В. Инфекция, вызываемая вирусом иммунодефицита человека в России. Терапевтический архив. 2016;88(11):4–11.[Pokrovskii VV. Infection, caused by human immunodeficiency virus in Russia. Terapevticheskii arkhiv. 2016;88(11):4–11. (In Russ)]
  2. Israel AM, Koziner B, Strauss DJ. Plasmacytoma and the acquired immunodeficiency syndrome. Ann Intern Med. 1983;99(3):635–6. doi: 10.7326/0003-4819-99-5-635.
  3. ВИЧ-инфекция и СПИД: Национальное руководство. Под ред. В.В. Покровского. М.: ГЭОТАР-Медиа, 2013. 608 с.[Pokrovskii VV, ed. VICh-infektsiya i SPID: natsional’noe rukovodstvo. (HIV and AIDS: national guidelines.) Moscow: GEOTAR-Media Publ.; 2013. 608 p. (In Russ)]
  4. Менделеева Л.П., Вотякова О.М., Покровская О.С. и др. Национальные клинические рекомендации по диагностике и лечению множественной миеломы. Гематология и трансфузиология. 2014;5(1, приложение 3):1–24.[Mendeleyeva LP, Votyakova OM, Pokrovskaya OS, et al. Natsional’nye klinicheskie rekomendatsii po diagnostike i lecheniyu mnozhestvennoi mielomy. (National clinical recommendations for diagnosis and therapy of multiple myeloma.) Gematologiya i transfuziologiya. 2014;5(1, Suppl 3):1–24. (In Russ)]
  5. Rajkumar SV, Kyle RA. Multiple myeloma: diagnosis and treatment. Mayo Clin Proc. 2005;80(10):1371–82. doi: 10.4065/80.10.1371.
  6. Kyle RA, Durie BG, Rajkumar SV, et al. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. Leukemia. 2010;24(6):1121–7. doi: 10.1038/leu.2010.60.
  7. Konstantinopoulos PA, Dezube BJ, Pantanowitz L, et al. Protein electrophoresis and immunoglobulin analysis in HIV-infected patients. Am J Clin Pathol. 2007;128(4):596–603. doi: 10.1309/QWTQFGA9FXN02YME.
  8. Kyle RA, Therneau TM, Rajkumar SV, et al. Prevalence of monoclonal gammopathy of undetermined significance. N Engl J Med. 2006;354(13):1362–9. doi: 10.1056/NEJMoa054494.
  9. Smith A, Howell D, Patmore R, et al. Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network. Br J Cancer. 2011;105(11):1684–92. doi: 10.1038/bjc.2011.450.
  10. Thomas MAB, Isbister JO, IbelsLS, et al. IgA kappa multiple myeloma and lymphadenopathy syndrome associated with AIDS virus infection. Aust NZ J Med. 1986;16(3):402–4. doi: 10.1111/j.1445-5994.1986.tb01198.x.
  11. Kaplan MH, Susin M, Pahwa SG, et al. Neoplastic complications of HTLV-III infection. Lymphomas and solid tumors. Am J Med. 1987;82(3):389–96. doi: 10.1016/0002-9343(87)90435-9.
  12. Voelkerding KV, Sandhaus LM, Kim HC, et al. Plasma cell malignancy in the acquired immune deficiency syndrome : association with Epstein-Barr virus. Am J Clin Pathol. 1989;92(2):222–8. doi: 10.1093/ajcp/92.2.222.
  13. Karnad AB, Martin AW, Koh HK, et al. Nonsecretory multiple myeloma in a 26-year-old man with acquired immunodeficiency syndrome, presenting with multiple extramedullary plasmacytomas and osteolytic bone disease. Am J Hematol. 1989;32(4):305–10. doi: 10.1002/ajh.2830320412.
  14. Gold JE, Schwam L, Castella A, et al. Malignant plasma cell tumors in human immunodeficiency virus-infected patients. Cancer. 1990;66(2):363–8. doi: 10.1002/1097-0142(19900715)66:2<363::aid-cncr2820660227>3.0.co;2-j.
  15. von Keyserlingk H, Baur R, Stein H, et al. Multiple myeloma in a patient at risk for AIDS. Cancer Detect Prev. 1990;14(3):403–4.
  16. Kumar S, Kumar D, Schnadig VJ, et al. Plasma cell myeloma in patients who are HIV-positive. Am J Clin Pathol .1994;102(5):633–69. doi: 10.1093/ajcp/102.5.633.
  17. Pizarro A, Gamallo C, Sanchez-Munoz JF, et al. Extramedullary plasmacytoma and AIDS-related Kaposi’s sarcoma. J Am Acad Dermatol. 1994;30(5):797–800. doi: 10.1016/s0190-9622(08)81519-8.
  18. Ventura G, Lucia MB, Damiano F, et al. Multiple myeloma associated with Epstein–Barr virus in an AIDS patient: A case report. Eur J Haematol. 1995;55(5):332–4. doi: 10.1111/j.1600-0609.1995.tb00706.x.
  19. Yee TT, Murphy K, Johnson M, et al. Multiple myeloma and human immunodeficiency virus-1 (HIV-1) infection. Am J Hematol. 2001;66(2):123–5. doi: 10.1002/1096-8652(200102)66:2<123::aid-ajh1028>3.3.co;2-g.
  20. Kentos A, Vekemans M, van Vooren JP, et al. High-dose chemotherapy and autologous CD34-positive blood stem cell transplantation for multiple myeloma in an HIV carrier. Bone Marrow Transplant. 2002;29(3):273–5. doi: 10.1038/sj.bmt.1703348.
  21. Aboulafia DM. Thalidomide-based treatment for HIV-associated multiple myeloma: a case report. AIDS. 2003;13(8):383–9.
  22. Amara S, Dezube BJ, Cooley TP, et al. HIV-Associated Monoclonal Gammopathy: A Retrospective Analysis of 25 Patients. Clin Infect Dis. 2006;43(9):1198. doi: 10.1086/508351.
  23. Gimeno E, Sorli L, Abella E, et al. Сomplete remission of smoldering myeloma in an HIV patient after highly antiretroviral therapy. Haematologica. 2007;92(Suppl 2):485, abstract 1348.
  24. Feller L, White J, Wood NH, et al. Extramedullary myeloma in an HIV-seropositive subject. Literature review and report of an unusual case. Head Face Med. 2009;5(1):4. doi: 10.1186/1746-160X-5-4.
  25. Muzaffar J, Usmani S, Abdallah AO, et al. High-dose chemotherapy and autologous stem cell transplantation for multiple myeloma in HIV-positive patients in the highly active antiretroviral therapy era: the myeloma institute of research and therapy experience. Clin Lymph Myel Leuk. 2013;13(2):171–4. doi: 10.1016/j.clml.2012.12.004.
  26. Agrawal S, Deshpande A. A unique presentation of multiple myeloma in an HIV patient. Indian J Med Res. 2013;137(4):815–6.
  27. Coker WJ, Jeter A, Schade H. Plasma cell disorders in HIV-infected patients: epidemiology and molecular mechanisms. Biomark Res. 2013;1(1):8. doi: 10.1186/2050-7771-1-8.
  28. Li G, Lewis RD, Mishra N, Axiotis CA. A retrospective analysis of ten symptomatic multiple myeloma patients with HIV infection: a potential therapeutic effect of HAART in multiple myeloma. Leuk Res. 2014;38(9):1079–84. doi: 10.1016/j.leukres.2014.07.001.
  29. Kyle RA, Rajkumar SV. Multiple myeloma. Blood. 2008;111(6):2962–72. doi: 10.1182/blood-2007-10-078022.
  30. Dezube BJ, Aboulafia DM, Pantanowitz L. Plasma cell disorders in HIV infected patients: from benign gammopathy to multiple myeloma. AIDS. 2004;14(7):372–4.
  31. Глинщикова О.А., Февралева И.С., Макарик Т.В. и др. Определение генетических полиморфизмов CCR5-∆32 и CCR2-64I у доноров и ВИЧ-1 инфицированных пациентов. Гематология и трансфузиология. 2014;59(приложение 1):39.[Glinshchikova OA, Fevraleva IS, Makarik TV, et al. Analysis of genetic polymorphisms CCR5-∆32 and CCR2-64I in donors and HIV-1 patients. Gematologiya i transfuziologiya. 2014;59(Suppl 1):39. (In Russ)]
  32. Heiko J, Todd AM, Streeck H. How a Single Patient Influenced HIV Research–15-Year Follow-up. N Engl J Med. 2014;370(7):682–3. doi: 10.1056/NEJMc1308413.
  33. Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78(1):21–33. doi: 10.4065/78.1.21.
  34. Blade J, Kyle RA. Multiple myeloma in young patients: clinical presentation and treatment approach. Leuk Lymphoma. 1998;30(5–6):493–501. doi: 10.3109/10428199809057562.