CNS Lymphoma in the Immunocompromised Host
Abstract The incidence of PCNSL is significantly increased in patients with either congenital or acquired immunodeficiencies. Infection with the human immunodeficiency virus (HIV) is one of the common causes of immunosuppression leading to PCNSL. PCNSL is diagnosed in patients with advanced HIV infection and extremely low CD4 counts, and therefore, there has been a dramatic decrease in its incidence in the highly active, anti-retroviral therapy (HAART) era. The prognosis of PCNSL in HIV patients in the pre-HAART era was dismal, leading some authorities to advocate a palliative approach. After the advent of HAART, the outcome of HIV-associated PCNSL (HIV-PCNSL) significantly improved in some series. However, in spite of the suggestion of a better outcome in more recent years, many (of the few) patients diagnosed with PCNSL in the HAART era are still managed in a palliative fashion. Thus, the prognosis of patients with HIV-PCNSL remains significantly worse than the prognosis of immunocompetent patients with PCNSL.
KeywordsHuman Immunodeficiency Virus Median Overall Survival Immunocompetent Patient Human Immunodeficiency Virus Patient Advanced Human Immunodeficiency Virus Infection
The author would like to thank Professor TA Lister for his helpful comments on the chapter. Silvia Montoto was kindly supported by grants from the Olivia Walduck family and the Ridgwell family.
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