Burkitt-like lymphomas in AIDS patients: Characterization within a series of 103 human immunodeficiency virus-associated non-Hodgkin's lymphomas

Purpose: Burkitt-like lymphoma (BLL) is a tumor with morphologic features i ntermediate between Burkitt's lymphoma (BL) and large-cell lymphoma, but it s relationship with these lymphomas is currently unclear. We have therefore analyzed its characteristics within a large series of human immunodeficien cy virus (HIV)associated lymphomas. Materials and Methods: Clinical, histologic, immunophenotypic, and molecula r analyses were performed on 103 patients with AIDS lymphomas. Results: Nineteen cases (18.4%) were identified as BLL. They were monoclona l B-cell proliferations, as evaluated by immunoglobulin (Ig) gene rearrange ment analyses, and had rearrangement of the c-myc oncogene in 68% of cases but not the bcl-2 gene, in contrast to a previous study on non-HIV-associat ed BLL. This molecular pattern was therefore identical to that of typical S t., suggesting that they represented tumors of similar origin. However, som e features could clearly differentiate BLL from St. and were similar to tho se seen in the diffuse large-cell immunoblastic lymphomas (DLC-IBL) group. These included a greater frequency of Epstein-Barr Virus (EBV) infection (7 9% v 48%, P = .04), an upregulation of CD39 (50% v 0%, P = .0007) and CD70 (75% v 15%, P = .003) activation antigens and of the CD11a/LFA-1 adhesion m olecule (83% v 30%, P = .05), and, finally, a lower CD4 count (mean, 119/mu L v 270/mu L, P = .04). Conclusion: BLL is a frequent entity among AIDS lymphomas and should be con sidered as a morphologic variant of BL in the context of severe immunodepre ssion that occurs in HIV-infected patients. (C) 1998 by American Society of Clinical Oncology.