Haematologica 2004;89: supplement no. 6 - Supplements ...

VIII Congress of the Italian Society of Experimental Hematology, Pavia, September 14-16, 2004183PosterLYMPHOMAS AND LYMPHOPROLIFERATIVEDISORDERS IIPO-197HHV-8 POSITIVE PEL IN A HIV-POSITIVE WOMAN FROMCENTRAL AFRICA WITH AGGRESSIVE KAPOSI SARCOMAAscoli V,* Natale ME,* Giannakakis K,* Dell'Isola S,°Mastroianni CM,° Calabrò ML, # Buffolino S, §Floriddia G, § Cimino G §*Dipartimento di Medicina Sperimentale e Patologia,°Dipartimento di Malattie Infettive e Tropicali,§Dipartimento di Biotecnologie Cellulari ed Ematologia,Università La Sapienza, Rome; # Dipartimento diScienze Mediche e Chirurgiche, Università di Padova,Padova, ItalyHuman herpesvirus 8 (HHV-8) associated primaryeffusion lymphoma (PEL) and Kaposi sarcoma (KS)are diseases primarily affecting men. HHV-8 is highlyprevalent in many African countries, wherein it isas common in women as in men. Since the epidemicof HIV, KS has become relatively more frequent inwomen and it can be aggressive and devastating(Nnoruka et al. Int J Dermatol 2003). We herein reportthe case of a HHV-8-positive PEL in a HIV-positive26-year-old black woman. She was born and livedfor 22 years in Cameroon, central Africa, then 4 yearsin Italy. The patient was graduated student whodenied intravenous drug abuse and declared heterosexualunprotected intercourse. Her past medical historywas negative except for malaria during childhood/adolescence.In July 2003 she became symptomaticwith progressive malaise. In August she developeda febrile syndrome associated with Shigella flexineri,and received a blood transfusion because ofsevere anemia (Hb 7.0 g/dL). Serologic test for HIVwas positive (HIV-RNA 5300 copies); CD4 8%; CD494/mm 3 ; CD8 61%. She underwent highly anti-retroviraltherapy. Nonetheless, the patient developedrecurrent pleural effusions, high fever and widespreadlymphoadenopatic, visceral and mucocutaneous KS.The course of disease was aggressive and deathoccurred in November. Effusions contained largeatypical lymphoid cells that were not numerous inthe first fluid but increased in number in the subsequentsamples. HHV-8 DNA sequences, but not EBV,were detected by PCR in peripheral blood mononuclearcells, saliva and in the pleural sediment. Antibodiesto the latent nuclear antigen (LNA-1) ORF 73revealed nuclear staining in atypical lymphoid cells.PCR analysis of the pleural sediment disclosed noclonal rearrangements of the Ig heavy chain gene.The failure of Ig PCR in PEL has been reported previously(Fais et al. Leukemia 1999; Hamoudi et al.Leukemia Research 2004). Sequencing of the ORF K1gene is in progress to document the HHV-8 strain.This case is an example of HHV-8 associated PEL inan African woman with HIV-related immunodeficiency.Few papers have described PEL in women: 6HIV-negative cases (Said et al. Blood 1996; Carboneet al. Br J Hematol 1996; Codish et al. Am J Hematol2000; Niitsu et al. Ann Hematol 2000; Boulanger etal. Am J Hematol 2004) and 1 HIV-positive case inwhich, however, the proof of HHV-8 infection is lacking(Valencia et al. AIDS 1999). To our knowledge,PEL has never been reported in Africans. In Cameroon,HHV-8 seroprevalence is high (28-62%; up to 55%in pregnant women), HHV-8 infection takes placeduring childhood by non-sexual casual routes, and KSwas relatively frequent also before the spread of HIVinfection epidemic (8/1000 men) (Gessain et al. Int JCancer 1999).PO-198EFFECT OF DEXRAZOXANE ON TOTAL PLASMA ANTIOXIDANTCAPACITY AND ON QT DISPERSION IN LYMPHOMA PATIENTSDURING ANTHRACYCLINE-BASED CHEMOTHERAPYCervetti G,* Franzoni F,° Galetta F,° Cecconi N,*Rossi A,* Femia FF,** Fazzi R,* Regoli F,** Santoro G,°Petrini M**Department of Hematology, °Department of InternalMedicine, University of Pisa, Pisa, **Institute ofBiology and Genetics, University of Ancona, ItalyAnthracyclines are widely used in the treatment oflymphomas but their clinical efficacy can be limitedby acute and chronic toxicity, in particular cumulativecardiac damage. Several approaches have beenattempted to reduce cytotoxicity of these antineoplasticagents, such the use of drugs with potentialcardio-protective action. Dexrazoxane clorhydrate(Cardioxane®), a synthetic bisdiketopiperazine tworingedcompound which hydrolyzes to an EDTA analog,seems to be able to reduce cardiac toxicity bybinding to free and bound iron, thus reducing theformation of anthracycline-iron complexes and thegeneration of free radicals which are toxic to cardiactissue. In daily practice, parameters of systolic function(left ventricular ejection fraction or fractionalshortening) are employed to detect cardiotoxicity, butthese methods are not able to identify acute cardiacdamage. The determination of QT dispersion mayidentify patients at risk of the development of earlyheart failure. The main purpose of the present studywas to assess the effect of epirubicin-based chemotherapy(PROMECECytaBOM) on plasma free radicalhaematologica vol. 89[suppl. n. 6]:september 2004