ISSN 1866-8836
Клеточная терапия и трансплантация

LY-06. Epidemiology of HIV-related plasmablastic lymphoma: the results of multicenter retrospective study in Russia

Yuliya A. Rogacheva1, Marina O. Popova1, Ivan V. Tsygankov1, Kirill V. Lepik1, Marina V. Demchenkova2, Tatyana V. Shneyder3, Maria A. Kolesnikova4, Tatyana I. Pospelova4, Vadim V. Baykov1, Natalya B. Mikhailova1, Alexander D. Kulagin1

1 RM Gorbacheva Research Institute of Pediatric Oncology, Hematology and Transplantation, Pavlov University, St. Petersburg, Russia
2 Irkutsk Regional Cancer Center, Irkutsk, Russia
3 Leningrad Regional Clinical Hospital, St. Petersburg, Russia
4 Novosibirsk City Hematology Center, Novosibirsk, Russia

Contact: Dr. Yuliya A. Rogacheva, e-mail:

doi 10.18620/ctt-1866-8836-2020-9-3-1-152



Plasmablastic lymphoma (PbL) is a rare and aggressive B-cell malignancy highly associated with HIV. Despite improved understanding of this disease, its prognosis remains poor, with short overall survival. There is no standard of care for this entity. Recent advances in the treatment of HIV-associated and aggressive lymphomas have not yet significantly improved the outcomes of patients with PbL.

Patients and methods

We investigated epidemiological characteristics and the results of treatment of PbL patients in large cohort of HIV-related lymphomas over a 7-year period (2014-2020). During the observation period, 26 cases of HIV-related PbL were registered in four centers and selected for analysis from the national multicenter retrospective study database. The median follow-up was 18.8 (4-55.4) months.


PbL accounted for 10% of lymphomas in HIV-infected patients (26/251). The median age was 39.5 years (32-61), males – 12 (46%). Most of the patients (n=23, 88%) had III-IV stages of the disease, and B-symptoms were present in 10 patients (38%). CNS involvement was revealed in 8 patients (30%). The median of ECOG score was I (I-III). Half of patients had viral hepatitis as a co-infection, including HCV (n=11), HBV (n=1), HCV and HBV (n=1), HCV, HBV and HDV (n=1). HIV and lymphoma were diagnosed simultaneously in 6 patients (23%). Median time from HIV infection to the lymphoma onset was 3.9 years (1.5 months to 17.5 years). Only one patient did not receive cART for unknown reason. At the time of starting chemotherapy (ChT), the median number of CD4+ cells was 156 cells/mcl (13 to 374). The frontline ChT regimens were as follows: CHOP±E, in 11 cases (42%); EPOCH, in 12 patients (46%); hyper-CVAD, in 1 case (4%); VCD, in 1 patient (4%); dexamethasone, 1 case (4%). Bortezomib was added to frontline treatment in 3 patients (11.5%); HDC with auto-HSCT had been done as a first-line therapy in 2 cases (7%). A total of 19 patients responded to the first-line therapy with overall response rate (ORR) of 73%, including CR and PR in 5 (26%) and 14 (74%) patients, respectively. The remaining patients had progression of the disease (n=6, 23%), or stable disease (n=1, 4%). The median number of ChT cycles to achieve the ORR was 4 (2 to 6 rounds). Overall survival (OS), progression-free survival (PFS) and time to progression (TTP) at 2 years after first line treatment was 61.5%, 42.3% and 44.3%, respectively. Ten patients received second-line ChT: DHAP (n=4, 40%); ICE (n=4, 40%); EPOCH (n=1, 10%); VBAP (n=1, 10%). Clinical response was evaluated in 9 patients, with CR, PR and progression of the disease registered in 1 (11%), 2 (22%), and 6 (67%) patients, respectively. PBSC harvesting was successful in 1 of 3 cases only (33%). This patient received HDC with auto-HSCT. OS, PFS and TTP rates at 2 years after second-line treatment were 50%, 10%, and 80%, respectively. Two years after second-line ChT, 4 patients were still alive, including those after ICE, EPOCH (n=2), HDC with auto-HSCT (n=1) and nivolumab (27 cycles) as a third line therapy (n=1).


In a large cohort of patients, PbL accounted for 10% of all HIV-related lymphomas. The patients with relapse of HIV-related PbL had worse prognosis. Prospective studies to improve the first-line chemotherapy are needed to optimize treatment of HIV-related plasmablastic lymphomas.


Plasmablastic lymphoma, HIV-associated, incidence, therapy, outcomes.

Volume 9, Number 3

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doi 10.18620/ctt-1866-8836-2020-9-3-1-152

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