High proportion of T-cell systemic non-hodgkin lymphoma in HIV-infected patients in Lima, Peru

Objective: Few reports have described the clinical and pathologic characteristics of HIV-related systemic non-Hodgkin lymphoma (sNHL) in developing countries. We aimed to determine these characteristics from a national HIV reference center in Peru and to evaluate factors associated with survival. Methods: A retrospective/prospective study of patients with HIV-related sNHL from the Guillermo Almenara General Hospital in Lima, Peru between 1993 and 2004. Clinical characteristics at diagnosis included age, gender, risk behavior, previous AIDS diagnosis, opportunistic diseases, previous highly active antiretroviral therapy, Karnofsky score, origin, clinical stage and B-cell symptoms of sNHL, and CD4⁺ cell count. Cases of sNHL were classified according to the criteria of the World Health Organization. Results: Thirty-three cases were identified (26 male, age range: 38 ± 10 years). Ten patients (30%) had a prior history of AIDS, 14 (42%) had a Karnofsky score of ≤70, and 18 (56%) had clinical stage IV sNHL. The CD4⁺ cell count median value was 111 cells/μL (n = 25). Twenty-four cases (73%) were B-cell sNHL, and 9 cases (27%) were T-cell sNHL, both from peripheral cells. Nineteen cases of sNHL were extranodal: 15 of B-cell origin and 4 of T-cell origin. Eighteen cases of B-cell sNHL had diffuse large cell histologic findings, and all cases of T-cell sNHL were unspecified. Although there were no significant differences in clinical characteristics between phenotypes, patients with T-cell sNHL had less aggressive disease and a better survival rate. Conclusions: A high proportion of T-cell sNHL cases was found at an HIV reference center in Peru. Clinical characteristics were similar between B-cell and T-cell lymphoma patients. T-cell lymphoma was less aggressive, and patients with T-cell lymphoma had a better survival rate than those with B-cell lymphoma.