Hematologic Aspects of HIV
Diagnosis and Pathophysiology
Non-Hodgkin's lymphoma among people with AIDS: incidence, presentation and public health burden: AIDS/Cancer study group.
Cote TR, Biggar RJ, Rosenberg PS, et al.
Int J Cancer. 1997;73:645-650.
Description: A large HIV population survey describing the public health burden of AIDS-related lymphoma (ARL) and the vastly increased risk of various subtypes of non-Hodgkin lymphoma in this group of patients.
PubMed citation number: 9398040
Highly effective treatment of acquired immunodeficiency syndrome-related lymphoma with dose-adjusted EPOCH: impact of antiretroviral therapy suspension and tumor biology.
Little RF, Pittaluga S, Grant N, et al.
Blood. 2003;101:4653-4659.
Description: Comparison of tumor characteristics and treatment outcomes in acquired immunodeficiency syndrome–related lymphomas (ARLs) compared with HIV-negative lymphomas after EPOCH therapy. The authors conclude that HAART may affect the tumor pathogenesis, which may explain the improved outcomes in ARLs in the HAART era.
PubMed citation number: 12609827
Primary effusion lymphoma: a distinct clinicopathologic entity associated with the Kaposi's sarcoma-associated herpes virus.
Nador RG, Cesarman E, Chadburn A, et al.
Blood. 1996;88:645-656.
Description: This study described the existence of a new AIDS-related lymphoma that is strongly associated with human herpes virus-8 (HHV-8) infection, thus suggesting a pathogenic role of HHV-8 in this distinct lymphoma.
PubMed citation number: 8695812
Epstein-Barr virus in AIDS-related primary central nervous system lymphoma.
MacMahon EM, Glass JD, Hayward SD, et al.
Lancet. 1991;338:969-973.
Description: This study demonstrated a 100% association between primary central nervous system lymphoma in AIDS patients and latent EBV infection, thus demonstrating a particularly important role for EBV in this subtype of AIDS-related lymphoma.
PubMed citation number: 1681341
The toxicity of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex: a double-blind, placebo-controlled trial.
Richman DD, Fischl MA, Grieco MH, et al.
N Engl J Med. 1987;317:192-197.
Description: The first report describing substantial hematologic toxicities associated with relatively high doses of AZT for the treatment of AIDS.
PubMed citation number: 3299090
Epidemiology of anemia in human immunodeficiency virus (HIV)-infected persons: results from the multistate adult and adolescent spectrum of HIV disease surveillance project.
Sullivan PS, Hanson DL, Chu SY, Jones JL, Ward JW.
Blood. 1998;91:301-308.
Description: The above study is a large epidemiologic study showing that: (1) the incidence of anemia increases with more advanced HIV infection; (2) anemia is an independent risk factor for death in HIV patients independent of viral load and CD4 count; and (3) recovery from anemia leads to increased survival.
PubMed citation number: 9414298
Pathogenesis and pathophysiology of anemia in HIV infection.
Kreuzer KA, Rockstroh JK.
Ann Hematol. 1997;75:179-87.
Description: Review of the evidence for multiple proposed mechanisms underlying HIV-associated anemia, including infection of erythroid progenitors, influence of cytokines, opportunistic infections, drug-induced myelosuppression, nutritional deficiencies, and inappropriately low erythropoietin levels.
PubMed citation number: 9433373
Cytopenias in HIV infection: mechanisms and alleviation of hematopoietic inhibition.
Koka PS, Reddy ST.
Curr HIV Res. 2004;2:275-282.
Description: Description of a SCID-hu mouse model to study the pathophysiology of the hematopoietic abnormalities induced by HIV-1 infection as well as by HAART treatment.
PubMed citation number: 15279591
Kinetic studies of the mechanism of thrombocytopenia in patients with human immunodeficiency virus infection.
Ballem PJ, Belzberg A, Devine DV, et al.
N Engl J Med. 1992;327:1779-1784.
Description: This was the first study of platelet kinetics in thrombocytopenic HIV patients and showed that thrombocytopenia is due to both increased platelet destruction and decreased production, and that treatment with AZT leads to increased platelet production.
PubMed citation number: 1435932
GPIIIa-(49-66) is a major pathophysiologically relevant antigenic determinant for anti-platelet GPIIIa of HIV-1-related immunologic thrombocytopenia.
Nardi MA, Liu L-X, Karpatkin S.
Proc Natl Acad Sci U S A. 1997;94:7589-7594.
Description: This study identified the specific epitope on GPIIIa to which antiplatelet antibodies are directed in patients with HIV-related immune thrombocytopenic purpura (ITP) and showed that the anti-GPIIIa antibodies are specific to patients with HIV-related ITP.
PubMed citation number: 9207136
Role of molecular mimickry to HIV-1 peptides in HIV-1-related immunologic thrombocytopenia.
Li Z, Nardi MA, Karpatkin S.
Blood. 2005;106:572-576.
Description: Peptide analysis supporting the theory that molecular mimickry in HIV-1–related ITP is the mechanism by which patients develop antibodies against GPIIIa.
PubMed citation number: 15774614
T cell dynamics in HIV-1 infection.
Douek DC, Picker LJ, Koup RA.
Annu Rev Immunol. 2003;21:265-304.
Description: Review discussing the pathophysiology and clinical manifestations of HIV-1 infection with respect to the effects on T-cell homeostasis and regeneration.
PubMed citation number: 12524385
Treatment
Highly effective treatment of acquired immunodeficiency syndrome-related lymphoma with dose-adjusted EPOCH: impact of antiretroviral therapy suspension and tumor biology.
Little RF, Pittaluga S, Grant N, et al.
Blood. 2003;101:4653-4659.
Description: This study: (1) demonstrated the safety of withdrawing HAART therapy during chemotherapy (with reinstitution at the completion of chemotherapy); (2) showed remarkable antilymphoma activity of dose-adjusted EPOCH; (3) correlated activity of the dose-adjusted EPOCH regimen with the biology of ARL; and (4) demonstrated a shift in the phenotype of ARL in the HAART era, with the more prognostically favorable germinal center B-origin lymphomas predominating over the pre-HAART postgerminal center B-origin lymphomas.
PubMed citation number: 12609827
AIDS-related Burkitt's lymphoma versus diffuse large-cell lymphoma in the pre-highly active antiretroviral therapy (HAART) and HAART eras: significant differences in survival with standard chemotherapy.
Lim ST, Karim R, Nathwani BN, Tulpule A, Espina B, Levine AM.
J Clin Oncol. 2005;23:4430-4438.
Description: Analysis of outcomes in HIV-related Burkitt’s lymphoma and DLCL with and without HAART, demonstrating improvement with HAART in HIV-DLCL, but no improvement in the poor survival with HIV-BL.
PubMed citation number: 15883411
Use of cytokines in human immunodeficiency virus-infected patients: colony-stimulating factors, erythropoietin, and interleukin-2.
Armstrong WS, Kazanjian P.
Clin Infect Dis. 2001;32:766-773.
Description: Review summarizing studies of G-CSF, GM-CSF, IL-2, and erythropoietin in the management of HIV-associated cytopenias or infections.
PubMed citation number: 11229845
Anemia in HIV infection: clinical impact and evidence-based management strategies.
Volberding PA, Levine AM, Dieterich D, Mildvan D, Mitsuyasu R, Saag M: Anemia in HIV Working Group. Clin Infect Dis. 2004;38:1454-1463.
Description: Evidence-based guidelines from the Anemia in HIV Working Group for the treatment of anemia in HIV patients. Consensus discussion of the prevalence of, risk factors for, and affect of anemia in patients with HIV.
PubMed citation number: 15156485
Review
Human immunodeficiency virus hematology.
Volberding PA, Baker KR, Levine AM.
Hematology (Am Soc Hematol Educ Program). 2003;294-313.
Description: The 3 sections in this ASH education program highlight issues in HIV important to a hematologist-oncologist consultant. The review covers antiretroviral drug development, the effects of HIV and its treatments on hematologic dyscrasias and clotting disorders, the pathogenesis and treatment of HIV-associated NHL, and Castleman disease.
PubMed citation number: 14633787
Haematological aspects of HIV infection.
Evans RH, Scadden DT.
Baillieres Best Pract Res Clin Haematol. 2000;13:215-230.
Description: Review of the effects of HIV or its treatment on hematologic parameters, including anemia, neutropenia, thrombocytopenia, and lymphopenia.
PubMed citation number: 10942622
Biology of anemia, differential diagnosis, and treatment options in human immunodeficiency virus infection.
Claster S.
J Infect Dis. 2002;185:S105-S109.
Description: Review of anemia in HIV, including discussion of its causes, evaluation, and treatment.
PubMed citation number: 12001030
HIV-related thrombocytopenia.
Scaradavou A.
Blood Rev. 2002;16:73-76.
Description: Review of the underlying pathophysiology and treatment of HIV-related thrombocytopenia.
PubMed citation number: 11914001
Human immunodeficiency virus infection and thrombotic microangiopathy.
Hymes KB, Karpatkin S.
Semin Hematol. 1997;34:117-125.
Description: Review of HIV and thrombotic microangiopathy.
PubMed citation number: 9109213