ABCL-189 The spectrum of HIV-associated hematological malignancies at a tertiary care centre in North India

Abstract

Context: With the introduction and widespread availability of highly active combined anti-retroviral therapy (HAART), the landscape of human immunodeficiency virus (HIV)-associated malignancies has changed. There is limited data on the pattern of hematological malignancies (HM) in HIV patients from India in the HAART era. Objective: We aimed to characterize the frequency and type of HM occurring in people with HIV at a tertiary care center in north India. Study Design and Patients In this study, we retrospectively analyzed the case records of patients diagnosed with HM and HIV infection between May 2013, and April 2023 registered in the Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi. Results: Twenty-three cases of HIV-associated HM were identified. Three patients were concurrently diagnosed with HIV, and 17 had a previous diagnosis of HIV. The median age at presentation was 40 years (range, 20-75 years). There were 20 males and three females in our cohort. The median CD4+ T-cell count was 290 cells/μl at diagnosis. Diffuse large B-cell lymphoma (DLBCL) was the most common histology in 12 patients (52.17%), followed by Hodgkin lymphoma in three patients (13%) and Burkitt's lymphoma in two patients (8.7%). Each patient had CML chronic phase, CML- blast crisis, anaplastic large cell lymphoma, multiple myeloma, plasmablastic lymphoma, and acute leukemia. Of 12 cases of DLBCL, 70% presented with advanced stage, high international prognostic score, and extranodal disease. Surprisingly, there were no reported cases of PCNSL or primary effusive lymphoma (PEL) with HIV. Conclusion: DLBCL is the most common HM in people living with HIV in north India and commonly presents with high-risk features.