This week's artwork was donated by Lonny, a pediatric cancer patient who received treatment at The Children's Hospital of Philadelphia . AIDS-related primary pulmonary lymphoma. Nonetheless, this entity has a particular presentation when compared to the disease occurring in immune-competent patients.
Mediastinal involvement is more unusual in immunocompromised than in immune-competent patients.
Due to either the immunodeficiency, antiretroviral treatments, poor hematological tolerance in response to chemotherapy, or to advanced anatomical stages, disease management may be hampered. From these observations, Hodgkin's disease management in HIV-infected patients relies on therapeutical approaches similar to those used for non infected patients, with some specific recommendations. Chemotherapy should be conducted in the shortest time in order to minimize chemotherapy-induced immunosuppression. Simultaneous use of antiretroviral treatment and reinforced opportunistic infection prophylaxis are of pivotal importance. Finally, the use of hematopoietic growth factors appears to be safe regarding viral replication, but still requires further evaluation.