Greater Incidence of Cytogenetic Aberrations in HIV-Positive Non-Hodgkin Lymphoma
Adam J Hoffhines, Nitin J Karandikar, Franklin S Fuda, Sara Monaghan, Prasad Koduru, Brian M Levenson. University of Texas Southwestern Medical Center, Dallas, TX
Background: Even in the era of combined antiretroviral therapy, HIV infection significantly increases the risk of developing non-Hodgkin lymphoma (NHL). HIV infection-related NHLs, like their HIV-negative counterparts, are associated with a variety of cytogenetic aberrations that often show correlation with different histopathologic subtypes, different anatomic sites of origin, and implicate different molecular pathways in malignant transformation. This study focused on comparing the frequency and complexity of cytogenetic lesions in NHLs of HIV-positive vs. HIV-negative patients.
Design: Our institution's databases were searched to identify 237 cases of NHL over a recent four-year period (9/07-8/11). After reviewing the electronic medical record, 78 of these cases met the following study criteria: 1) documented HIV testing and 2) conventional cytogenetic studies (+/- FISH) of treatment-naïve tissue from either the tumor or involved bone marrow (with at least 20% involvement). Cases were classified on the basis of their cytogenetics as 'normal,' 'simple' (1-2 cytogenetic aberrations), or 'complex' (≥3 cytogenetic aberrations). Chi-squared analysis was used to test for statistical significance between HIV(+) and HIV(-) case distributions.
Results: Ten (12.8%) of 78 cases were HIV-positive. Common diagnoses in HIV(+) cases were: diffuse large B-cell (40%), Burkitt (30%), and plasmablastic (20%); whereas those in HIV(-) cases were: diffuse large B-cell (26.5%), CLL/SLL (20.6%), and follicular (16.2%). All HIV(+) cases (10/10, 100%) showed cytogenetic aberrations [0 (0%) normal, 5 (50%) simple, 5 (50%) complex], which included t(8;14) (60%). In contrast, only 50/68 (73.5%) of HIV(-) cases showed cytogenetic abnormalities [18 (26.5%) normal, 18 (26.5%) simple, 32 (47%) complex]. These included t(14;18) (23.5%), +7 (10.3%), and t(8;14) (5.9%). While the overall distribution into the three cytogenetic classifications was not statistically different (p=0.116), there was a trend toward a higher proportion of HIV(+) cases showing at least one cytogenetic aberration (p=0.064), suggesting greater genetic instability in the presence of HIV infection.
Conclusions: The current study shows a trend of overall increased frequency of cytogenetic abnormalities in NHLs from HIV(+) patients compared with HIV(-) patients. This suggests greater genetic instability in this setting. We are currently expanding this database to test the significance of these findings in specific NHL categories and to detect any recurrent abnormalities that may be uniquely HIV-associated.
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 192, Tuesday Afternoon