Key clinical point: Epstein-Barr virus co-infection was more common in the HIV-infected group.

Major finding: DLBCL subtypes were not significantly associated with overall survival or infection with HIV, EBV.

Study details: Retrospective cohort analysis of 181 patients with DLBCL; 131 HIV-uninfected, 50 HIV-infected.

Disclosures: The research was supported by the National Institutes of Health. The authors reported that they had no conflicts.

Commentary

“Diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) is categorized into germinal centre B-cell (GCB) and activated B-cell (ABC) molecular subtypes. Patients with ABC DLBCL have worse outcomes compared to those with GCB when treated with standard immunochemotherapy. However, Drs. Cassim et al found that molecular subtype was not associated with outcome in 50 HIV positive patients with DLBCL who were compared to 131 HIV negative patients with DLBCL in a retrospective study. The key predictor of poor outcome in the HIV positive patients was CD4 level <150 cells/mm3. A minority of patients in this study also had Epstein-Barr virus (EBV) expressed in tumor tissue. EBV positivity was not associated with outcome or molecular subtype. Future prospective studies should include HIV positive DLBCL patients in order to continue to gain understanding of the disease process and response to standard and novel therapies in these patients.”

Sarah Rutherford, MD

Assistant Professor of Medicine, Weill Cornell Medicine