Durable complete remissions in HIV-associated Hodgkin lymphoma after treatment with only one cycle of chemotherapy complicated by sepsis.
The infiltration of nonmalignant cells surrounding the Reed-Sternberg cells within the tumors of Hodgkin lymphoma (HL) might be central to the pathophysiology of the disease. Severe sepsis results in a flood of cytokines that activate the immune system and is associated with generalized lymphocyte apoptosis. We report on 2 patients with HIV infection and HL who achieved durable complete remissions following only one cycle of chemotherapy that was complicated by neutropenic sepsis. An understanding of the pathophysiology of sepsis and immunologic activation that appear to have led to these long-term remissions might lead to novel therapeutic approaches for patients with HL.