AIDS-Related Lymphomas - Causes, Symptoms, and Treatment

What Is AIDS (Acquired Immune Deficiency Syndrome)?

AIDS (Acquired Immune Deficiency Syndrome) is a viral disorder caused by an immunodeficiency virus affecting the immune system. It is a sexually transmitted disease or coming in contact with contaminated body fluids which has been affected by the human immunodeficiency virus. The human immunodeficiency virus targets the body’s immune cells and makes an individual more susceptible to infections. It leads to the falling of CD4 cells in the blood and increases the risk of other infections. AIDS (acquired immune deficiency syndrome) is the last stage of the viral disease. Managing the disorders is possible with advanced treatment modalities like antiretroviral drug therapy. The medication for AIDS (acquired immune deficiency syndrome) causes the reduction of the viral load, which helps an individual to lead a normal life.

What Is Lymphoma?

Lymphomas are a type of malignancy involving lymphocytes of the immune system. Lymphocytes are produced in the bone marrow, and lymph nodes are the reservoir of the lymphocytes. Excessive proliferation or dysfunctional lymphocytes leads to the development of lymphomas. There are two types of lymphomas – Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma. It leads to swollen lymph nodes, breathlessness, fever, night sweats, and weight loss. Lymphoma is a treatable disorder with the indication of chemotherapy, radiation therapy, and immunotherapy.

What Is AIDS-Related Lymphoma?

AIDS (acquired immune deficiency syndrome) related lymphoma is a malignant disorder.

Human immunodeficiency virus (HIV) is the main cause of AIDS (acquired immune deficiency syndrome), which weakens the immune system by attacking the immune cells and increases the risk of other infections and other diseases like lymphomas. AIDS-related lymphoma affects the body's lymphatic system, and it can be of two types – Non-Hodgkin’s Lymphoma and Hodgkin’s Lymphoma.

The lymphatic system of the body consists of -

1. Lymph - It is a colorless, watery fluid that flows through the lymphatic vessels in the body. The lymphatic fluid consists of B-lymphocytes and T-lymphocytes.

2. Lymph Vessels - Lymph vessels are the tubes that carry the lymph.

3. Lymph Nodes - Lymph nodes are small bulbs-like structures present in the body and function as the storage of the lymphatic fluids containing B-lymphocytes and T-lymphocytes, which are the type of white blood cells. Lymph nodes are present all over the body in different regions like - the neck, armpits, pelvis, abdomen, mediastinum, and groin.

4. Spleen - Spleen is an internal organ present on the left side of the body in the abdominal region. The spleen helps in the storage and destruction of red blood cells.

5. Thymus - It is an organ present in between the chest and helps in the maturation and storage of the T-lymphocytes.

6. Tonsils - Tonsils are also part of the lymphatic system and are present on the back side of the neck.

7. Bone Marrow - Bone marrow is a spongy tissue between the long bones; it helps produce blood and its components like white blood cells, red blood cells, and platelets. Sometimes, AIDS-related lymphoma is also seen outside the lymphatic system, like in the liver, meninges, and gastrointestinal tract.

What Are the Signs and Symptoms of AIDS-Related Lymphoma?

AIDS (acquired immune deficiency syndrome) related lymphoma has the following signs and symptoms -

1. Weakness.

2. Fatigue.

3. Weight loss.

4. Night sweats.

5. Fever.

6. Lymphadenopathy (swollen lymph nodes).

7. Shortness of breath.

8. Abdominal discomfort.

9. Diarrhea.

10. Headache.

11. Recurring infections.

12. The feeling of fullness in ribs.

What Are the Stages of AIDS-Related Lymphoma?

The staging of AIDS-related lymphoma is done to diagnose the spread of the malignancy. Staging is done according to the involvement of lymph nodes of different parts of the body.

• Stage I - Involvement of a single lymph node region.

• Stage II - The involvement of two or more lymph node regions on the same side of the diaphragm is seen.

• Stage III - Involvement of lymph nodes on both sides of the diaphragm.

• Stage IV - Multifocal involvement of one or more different lymphatic sites with or without associated lymph nodes.

What Are the Investigations for the Diagnosis of AIDS-Related Lymphoma?

The following investigation is indicated for the diagnosis of AIDS-related lymphoma -

• Physical Examination - It is important to examine the patient physically, checking the vitals, inspection, palpation, and auscultations to understand the signs and symptoms described.

• Family History - Recording personal and family history for understanding the patients' habits and previous medical conditions.

• Complete Blood Count - A blood test is performed to determine the count of blood cells and hemoglobin content.

• Blood Chemistry Test - It is performed to measure certain substances released by the body.

• Lactic Dehydrogenase Test - It is an enzyme in the blood; usually, it gets elevated at the time of tissue damage.

• HIV Test - This investigation is done to determine the presence of HIV antibodies in the blood. An individual affected with HIV shows a high level of antibodies.

• CT Scan (Computerized Tomography) - It is an imaging test used to check the spread of the disorder.

• Bone Marrow Biopsy and Aspiration - In this investigation, a sample is collected from the bone marrow to examine the changes in the collected sample.

• Lymph Node Biopsy - Biopsy is done by removing a part or complete lymph node for the investigation.

• Immunophenotyping - It is done to determine the cancer cells using antibodies.

What Are the Treatment Modalities for AIDS-Related Lymphomas?

AIDS-related lymphomas are treatable disorders with different modes of treatment.

Following are the treatment advised for managing AIDS-related lymphomas -

1. Chemotherapy - It is done by injecting anticancer drugs through veins, and the medicine flows into the bloodstream and kills the neoplastic cells. When the chemotherapy is given through muscles and veins, it is known as systemic chemotherapy; when it is placed and directed through cerebrospinal fluid, it is called intrathecal chemotherapy, and if the drugs are injected through a body cavity, it is called regional chemotherapy.

2. Radiotherapy - High-energy X-rays are used for the treatment; the X-rays are directed toward the affected part of the body to minimize the destruction of normal cells and tissues of the body. This therapy reduced the pain of the patient.

3. Targeted Therapy - This therapy is done with monoclonal antibodies like Rituximab, which binds with B-cells and induces complement-mediated lysis, direct cytotoxic activity, and apoptosis (cell death).

4. Chemotherapy with stem cell transplantation.

Conclusion:

AIDS-related lymphoma is a cancerous disorder usually seen in an individual with the human immunodeficiency virus. Living with the disorder is manageable with proper indicated treatment and under the guidance of a specialist doctor.