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Epstein-Barr virus infection is associated with clinical characteristics and poor prognosis of multiple myeloma. Biosci Rep 2020; 39:BSR20190284. [PMID: 30967494 PMCID: PMC6822490 DOI: 10.1042/bsr20190284] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 11/17/2022] Open
Abstract
The aim of the present study was to evaluate the relationship of Epstein-Barr virus (EBV) infection and multiple myeloma (MM) and its impact on clinical characteristics and prognosis. Fresh peripheral blood mononuclear cells (PBMCs) from 139 MM patients who had been diagnosed and treated from January 2010 to May 2018 and 50 PBMC samples from healthy donors were obtained. PCR was carried out for detection of EBV-DNA. The results indicated a significantly higher EBV-DNA concentration among 139 MM patients compared with healthy controls (P<0.05). Correlation analysis showed that the expression of EBV-DNA was positively correlated with the serum free light chain ratio (sFLCR) and progressive disease (PD)/relapse (P<0.05). Especially, in EBV-DNA high-expression MM patients, EBV-DNA concentration for patients with sFLCR ≥100 was higher than that of patients with sFLCR <100. EBV-DNA concentration was higher in patients with disease PD/relapse than those without disease PD/relapse. In univariate analysis, the progress free survival (PFS) was inferior in MM patients with high expression of EBV-DNA, high lactate dehydrogenase (LDH), and high-risk according to mSMART and International Myeloma Working Group (IMWG), stage III according to R-ISS staging, extramedullary lesions, and genetic changes (P<0.05). However, in multivariate analysis, LDH, poor karyotype, R-ISS staging, and mSMART were independent prognostic factors for PFS. Taken together, our studies suggest that an association exists between EBV infection and clinical characteristics of MM patients, and EBV infection appears to have a slight impact on the prognosis of MM. However, the results require further validation in other independent prospective MM cohorts.
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Mameli G, Fozza C, Niegowska M, Corda G, Ruda MF, Barraqueddu F, Dessì L, Podda L, Dore F, Sechi LA. Epstein-Barr virus infection is associated to patients with multiple myeloma and monoclonal gammopathy of undetermined significance. Leuk Lymphoma 2016; 58:466-469. [PMID: 27268403 DOI: 10.1080/10428194.2016.1190976] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Giuseppe Mameli
- a Department of Biomedical Sciences , University of Sassari , Sassari , Italy
| | - Claudio Fozza
- b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy
| | - Magdalena Niegowska
- a Department of Biomedical Sciences , University of Sassari , Sassari , Italy
| | - Giovanna Corda
- b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy
| | - Maria Francesca Ruda
- b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy
| | - Francesca Barraqueddu
- b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy
| | - Laura Dessì
- b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy
| | - Luigi Podda
- b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy
| | - Fausto Dore
- b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy
| | - Leonardo A Sechi
- a Department of Biomedical Sciences , University of Sassari , Sassari , Italy
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Cheung MC, Pantanowitz L, Dezube BJ. AIDS-related malignancies: emerging challenges in the era of highly active antiretroviral therapy. Oncologist 2005; 10:412-26. [PMID: 15967835 DOI: 10.1634/theoncologist.10-6-412] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Human immunodeficiency virus (HIV)-infected patients are at increased risk of developing cancer, particularly in the later stages of acquired immune deficiency syndrome (AIDS). Despite the advent of highly active anti-retroviral therapy (HAART), malignancy in this population is a leading cause of morbidity and mortality. Kaposi's sarcoma (KS) and AIDS-related non-Hodgkin's lymphoma (ARL) are the most common AIDS-defining malignancies. AIDS-related KS varies from minimal to fulminant disease. Treatment decisions for AIDS-related KS are guided largely by the presence and extent of symptomatic disease. In addition to HAART, excellent treatments exist for both localized disease (topical gel, radiotherapy, and intralesional therapy) and advanced disease (liposomal anthracyclines, paclitaxel). Novel therapies that have become available to treat AIDS-related KS include angiogenesis inhibitors and antiviral agents. ARL comprises a heterogeneous group of malignancies. With the immune restoration afforded by HAART, standard-dose chemotherapies now can be safely administered to treat ARL with curative intent. The role of analogous treatments used in HIV-negative patients, including monoclonal antibodies and autologous stem cell transplantation, requires further clarification in HIV-positive patients. HIV-infected patients also appear to be at increased risk for developing certain non-AIDS-defining cancers, such as Hodgkin's lymphoma and multiple myeloma. Although the optimal treatment of these neoplasms is at present uncertain, recent advances in chemotherapy, antiretroviral drugs, and supportive care protocols are allowing for more aggressive management of many of the AIDS-related cancers. This article provides an up-to-date review of the epidemiology, pathogenesis, clinical features, and treatment of various AIDS-related malignancies that are likely to be encountered by an oncologist practicing in the current HAART era.
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MESH Headings
- Acquired Immunodeficiency Syndrome/complications
- Antiretroviral Therapy, Highly Active
- Education, Medical, Continuing
- Hodgkin Disease/drug therapy
- Hodgkin Disease/etiology
- Hodgkin Disease/pathology
- Humans
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/etiology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/etiology
- Lymphoma, Non-Hodgkin/pathology
- Medical Oncology/trends
- Prognosis
- Risk Factors
- Sarcoma, Kaposi/drug therapy
- Sarcoma, Kaposi/etiology
- Sarcoma, Kaposi/pathology
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Affiliation(s)
- Matthew C Cheung
- Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Cisteró B, Sala M, Soler A, García N. Talidomida en el tratamiento de los plasmocitomas recurrentes de un paciente infectado por el VIH. Med Clin (Barc) 2004; 122:595-6. [PMID: 15144751 DOI: 10.1016/s0025-7753(04)74318-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bühler S, Laitinen K, Holthöfer H, Järvinen A, Schauman KO, Hedman K. High rate of monoclonal gammopathy among immunocompetent subjects with primary cytomegalovirus infection. Clin Infect Dis 2002; 35:1430-3. [PMID: 12439809 DOI: 10.1086/344465] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2002] [Accepted: 07/11/2002] [Indexed: 11/03/2022] Open
Abstract
Serum samples from immunocompetent adults with primary cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection and from solid-organ or bone marrow transplant recipients with primary CMV infection were examined for paraproteins. Several immunocompetent patients with CMV infection but none with EBV infection presented with an M component, which implies that the M component connects CMV infection to a risk of B cell malignancy.
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Affiliation(s)
- Suvi Bühler
- Department of Virology, Helsinki University Central Hospital, FIN-00029 HUCH, Helsinki, Finland.
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Herranz S, Sala M, Cervantes M, Sasal M, Soler A, Segura F. Neoplasia of plasma cells with atypical presentation and infection by the human immunodeficiency virus. A presentation of two cases. Am J Hematol 2000; 65:239-42. [PMID: 11074542 DOI: 10.1002/1096-8652(200011)65:3<239::aid-ajh11>3.0.co;2-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Neoplasia of plasma cells acquires special clinical characteristics in patients infected by human immunodeficiency virus (HIV). These patients are much younger at the time of diagnosis, and when they are compared with the general population they show an atypical clinical evolution, with a greater frequency of solitary plasmacytomas, less evidence of a monoclonal plasmatic component, or greater aggressiveness of the neoplastic process. This paper provides the most significant data on two patients infected by HIV and diagnosed for plasma cell neoplasia. Recent pathogenetic hypotheses for plasma cell neoplasias that include immune alterations, chronic viral infections, and hyperexpression of cytokines exist in patients infected by HIV, and this could suggest that this type of neoplasia is another malignant haematological process associated with AIDS.
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Affiliation(s)
- S Herranz
- Internal Medicine Department, Corporació Sanitària del Parc Taulí, Sabadell, Barcelona, Spain
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Delèvaux I, Bernard N, Ramanampamonjy R, Morlat P, Lacoste D, Bonnet F, Bonnel C, Deminière C, Beylot J. [Multiple medullary and extramedullary plasmacytomas in an HIV infected female patient]. Rev Med Interne 2000; 21:623-7. [PMID: 10942979 DOI: 10.1016/s0248-8663(00)80008-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Before the HIV infection era, plasmocyte tumor rarely occurred in patients younger than 40 years of age. Less frequent than lymphomas, the incidence of these blood diseases has however substantially increased in HIV-infected patients. In these patients, in addition to onset at earlier age, their clinical presentation is quite different and extramedullary plasmocytomas in unexpected locations are more common. EXEGESIS We report the case of a 29-year-old HIV-infected female patient in whom were diagnosed occipital, parotidal, sphenoidal, epidural, and uterine plasmocytomas for which chemotherapy and subsequent radiotherapy were successful. The increase in the incidence of plasmocyte tumors in HIV-infected patients might be facilitated by Epstein Barr Virus (EBV) co-infection, HIV-related chronic antigenic stimulation, and secretion of interleukin 6 by infected lymphocytes. CONCLUSION Plasmocyte tumors belong to neoplasia whose incidence is increased in HIV infection. Their currently poor diagnosis should be improved by highly active antiretroviral therapies allowing enhanced chemotherapy with possibility of autograft.
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Affiliation(s)
- I Delèvaux
- Service de médecine interne et de maladies infectieuses, hôpital Saint-André, Bordeaux, France
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Cauda R, Lucia MB, Marasca G, Rutella S, Petrucci MT, La Verde G, Gastaldi R. Beneficial effect of highly active antiretroviral therapy (HAART) in reducing both HIV viral load and monoclonal gammopathy. Eur J Haematol 1999; 63:134-5. [PMID: 10480293 DOI: 10.1111/j.1600-0609.1999.tb01127.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pulik M, Genet P, Jary L, Lionnet F, Jondeau K. Acute myeloid leukemias, multiple myelomas, and chronic leukemias in the setting of HIV infection. AIDS Patient Care STDS 1998; 12:913-9. [PMID: 11362062 DOI: 10.1089/apc.1998.12.913] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
B-cell lineage-derived high-grade malignant lymphomas are a well-recognized complication of HIV infection. However, isolated cases of unusual hematologic malignancies such as acute myeloid leukemias (AML), multiple myeloma (MM) or plasmacytomas, and chronic leukemias have been reported. This review focuses on these uncommon malignancies supervening in the setting of HIV infection. Eighteen cases of AML have been reported. Extramedullary localizations are frequently noticed. Nontreated patients have a survival of 2.7 weeks, compared with 9.8 months for patients treated with chemotherapy; being HIV-positive is not a contraindication to the treatment of AML. Based on the observed 72% incidence of AML M4 and M5 in an HIV-infected population versus 19% to 36% expected in a non-HIV-infected population, we postulate that the association of AML and HIV is not coincidental. The monocytotropism of HIV, the chronic cytokine-mediated activation of monocytes/macrophages, and the immunodeficiency may explain this association. Twenty-two cases of MM or plasmacytomas have been described, most of them in young patients. Again, extramedullary plasma cell tumors are recorded in many patients. Physiopathologic studies suggest that MM may develop because of an antigen-driven response to the circulating viral antigens. A role for Epstein-Barr virus (EBV) in the pathogenesis, as previously described in high-grade non-Hodgkin's lymphomas, is suggested by the presence of EBV genomes in plasma cell tumors. Finally, a broad spectrum of chronic leukemias derived from B- or T-cell lymphocyte lineage has been reported. These associations seem coincidental.
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Affiliation(s)
- M Pulik
- Service d'Hématologie, Centre Hospitalier d'Argenteuil, France
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Lallemand F, Fritsch L, Cywiner-Golenzer C, Rozenbaum W. Multiple myeloma in an HIV-positive man presenting with primary cutaneous plasmacytomas and spinal cord compression. J Am Acad Dermatol 1998; 39:506-8. [PMID: 9738796 DOI: 10.1016/s0190-9622(98)70339-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- F Lallemand
- Department of Infectious Diseases, Hôpital Rothschild, Paris, France
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