Cohort of HIV Associated Lymphomas (ANRSCO16)

The incidence of lymphomas is increased among HIV infected patients. In 70 % of cases, those are Non Hodgkin's lymphomas (NHL) and Hodgkin lymphomas (HL) in 30% of cases. In France, their incidence is estimated to 100 cases per year (data from the "Base de données Hospitalière Française sur l'Infection à VIH" (FHDH)). The main mechanisms involved in lymphomagenesis are immune dysfunction, involvement of oncogenic viruses (Epstein-Barr (EBV) and HHV8) and molecular oncogenic events. A better understanding of these different pathways, give the possibility to design specific treatments. The treatment of these lymphomas is not standardized. A prospective study of patients with HIV associated lymphoid malignancies is an innovating tool to answer epidemiological, physiopathological and therapeutic questions. We propose a prospective multicentric study of these patients.

The main objectives of this prospective study are to:

• evaluate the incidence, characterise clinically and histologically NHL and HL cases associated to HIV
• perform an observational study of the treatment and outcome of these patients out of the context of clinical trials,
• study the differentiation and activation of B-cell populations,
• better understand the role of specific T cell responses in the control of EBV infection,
• allow other biological studies from the ANRS group " Lymphome et VIH ".

The recruitment of 80 cases per year is expected. The length of inclusions is 7 years. The follow-up will be of 5 years. Clinical, pathological and biological data at diagnosis and during follow-up will be collected. This will allow characterizing the lymphoma, the HIV infection, the antitumoral treatments and the outcome of lymphoma. Biological samples will be centralized to collect cell, DNA, RNA, plasma, serum and tumour collections (Y.Taoufik, M.Raphael* ). To better understand the EBV infection and lymphomagenesis in HIV infection, we propose to follow the viral load and the molecular characteristics of EBV in PBMC, plasma and tumour (P.Morand* , V.Boyer* ), to investigate the EBV-T cell responses (G.Carcelain) and the presence and reactivation of EBV in peripheral B cells (C.Amiel* , JC Nicolas) and in tumoral samples (M.Raphael* , I.Joab* ). The other mechanisms of lymphomagenesis in HIV infection will be studied by the analysis of the sub-populations of B-cells in terms of activation and differentiation (Y.Taoufik) and by the characterization of MSI tumours (A.Duval).

The recruitment of 80 cases per year is expected. The length of inclusions is 5 years. The follow-up will be of 5 years. Clinical, pathological and biological data at diagnosis and during follow-up will be collected. This will allow characterizing the lymphoma, the HIV infection, the antitumoral treatments and the outcome of lymphoma. Biological samples will be centralized to collect cell, DNA, RNA, plasma, serum and tumour collection.

Inclusion Criteria:

• Male and female patients over 18 years of age
• patients with HIV-1 or 2 infection
• with Non Hodgkin's lymphomas (NHL) or Hodgkin lymphomas (HL) in the diagnosis or in relapse
• sign an informed consent

Exclusion Criteria:

• patients who suffered from acute leukemia
• patients treated for lymphoïd blood disease
• Patients whose lymphomas treatment was stopped for less than 3 months
• unaffiliated to the social healthy security french system

• Collect cell and immune study
• Dr Yassine Taoufik Dr Houria Chavez Hôpital Bicêtre CIB Paris Sud France
• Dr Guislaine Garcelain Hôpital Pitié Slapétrière Paris France
• Virology study
• Dr Patrice Morand et Veronique Boyer CHU Grenoble France Dr Corinne Amiel Hopital Tenon Paris France
• Dr Irène Joab Hôpital Paul Brousse Villejuif France
• Anatomo-pathologie
• Pr Sophie Prévot Hôpital Béclère France
• Génétique des tumeurs
• Dr Alex Duval Fondation Jean Dausset CEPH