• AIDS-related Lymphoma

    (HIV-Associated Lymphoma, AIDS-Related Non-Hodgkins Lymphoma)

    Definition

    Lymphomas are cancers of the lymph system. The lymph system has a series of nodes, channels, and tissue throughout the body. The lymph creates and carries white blood cells that fight infections in the body. Lymphoma starts in these white blood cells.
    AIDS-related lymphoma is one that develops in people with HIV or AIDS. If someone with HIV develops lymphoma, it is one of many complications that show that AIDS has developed.
    Though there are different types of lymphoma, AIDS-related lymphoma is most often non-Hodgkins lymphoma (NHL). NHL does develop in people without HIV, but AIDS-related lymphoma can be more aggressive.
    The Lymphatic System
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Cancer occurs when cells in the body divide without control or order. If cells keep dividing uncontrollably, a mass of tissue forms, called a growth or tumor. Because the lymph system is spread throughout the body, there may be several areas affected. However, the cancer is not considered spread, or metastasized, unless it develops in tissue outside of the lymph system.
    NHL cancer starts because of damage to the DNA when a new white blood cell is made. The damaged DNA instructs the cells to divide and grow abnormally. The damaged cell may then split and create new damaged cells. It is not clear what causes this change to DNA but it may be a combination of genetic and environmental factors.

    Risk Factors

    Having HIV increases the risk of AIDS-related lymphoma.
    HIV damages certain white blood cells in the body that help control cancer. The body will try to create more white blood cells to make up for the damaged cells. This may result in the increased creation of another type of white blood cell that develops into lymphoma.
    HIV also lowers the immune system in general making people more vulnerable to cancer.

    Symptoms

    Because the lymph system is spread across the body, symptoms can be widespread. Symptoms may include:
    • Swelling in the neck, chest, underarm, or groin
    • Unexpected weight loss
    • Fever
    • Night sweats
    • Fatigue
    • Itchy skin

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.
    Your body fluids and tissues may be tested. This can be done with:
    Tests may be done to determine the stage of the cancer. Staging is a careful attempt to determine whether the cancer has spread and, if it has, what body parts are affected.
    Images may be taken of your body structures. This can be done with an:

    Treatment

    Treatment depends on the type, aggressiveness, and stage of the cancer. Treatment for AIDS will start or continue as well.
    Cancer treatments can further weaken the immune system so it is important to manage HIV infection and keep the immune system as strong as possible. Treatment for HIV infection includes highly active antiretroviral therapy (HAART). These medications can help slow the progress of HIV infection and improve the immune system. Changes may need to be made to HIV medication if chemotherapy is started to prevent interactions.
    Treatment for the lymphoma may include:

    Chemotherapy

    Chemotherapy involves the use of drugs to kill cancer cells. The drugs enter the bloodstream then travel through the body. While chemotherapy is focused on killing cancer cells, some healthy cells are affected as well. The impact on the healthy cells can cause a range of side effects.
    Chemotherapy is a common choice of treatment for lymphoma because it can affect cells all over the body. This therapy is often delivered over a number of cycles with a few weeks of rest after a few days of treatment.
    Steroid medication may be given with chemotherapy to make chemotherapy more effective. This medication may also decrease some of the side effects common with chemotherapy.

    Monoclonal Antibody Therapy

    Antibodies are an important part of the immune system. They signal which substances in the body need to be attacked by the immune system. Monoclonal antibodies are medications that are specially made to stick to the surface of cancer cells and signal the immune system to attack.

    Radiation Therapy

    Radiation therapy delivers radiation to a specific area of the body. Because lymphoma can be so widely spread, radiation therapy is not as common in treatment of lymphoma. It may be used in combination with chemotherapy for areas with larger growths. The radiation may shrink growths that are causing pain or interfering with function of local tissue.

    Prevention

    There are no current guidelines to prevent AIDS-related lymphoma. Carefully managing HIV or AIDS may help keep the immune system strong and decrease the risk of certain cancers.

    RESOURCES

    Centers for Disease Control and Prevention http://www.cdc.gov

    National Cancer Institute http://www.cancer.gov

    CANADIAN RESOURCES

    AIDS Committee of Toronto www.actoronto.org

    Canadian AIDS Society http://www.cdnaids.ca

    References

    AIDS-related lymphoma treatment. National Cancer Institute website. Available at: http://www.cancer.gov/types/lymphoma/patient/aids-related-treatment-pdq. Updated October 21, 2014. Accessed December 15, 2014.

    HIV infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114424/HIV-infection. Updated September 28, 2016. Accessed October 3, 2016.

    HIV-related lymphoma. Macmillan Cancer Support website. Available at: http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Lymphomanon-Hodgkin/TypesofNHL/HIVrelatedlymphoma.aspx. Updated April 1, 2014. Accessed December 15, 2014.

    Revision Information

    • Reviewer: EBSCO Medical Review Board David Horn, MD
    • Review Date: 03/2017
    • Update Date: 10/03/2016
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