Daratumumab-Based Therapy in HIV-Associated Plasmablastic Lymphoma: A Single-Center Experience from a Mexican Referral Institution
Materials and Methods/Case Presentation/Objective: We performed a retrospective single-center cohort study including consecutive adult patients with histopathologically confirmed HIV-associated plasmablastic lymphoma treated at the Hematology Department of Hospital Central Militar, Mexico, between January 2022 and December 2025. Demographic characteristics, HIV-related parameters, disease stage, pathological findings, treatment regimens, response to therapy, and survival outcomes were extracted from electronic medical records. Clinical responses were assessed according to treating physician documentation and available imaging studies. Overall survival was defined as the time from diagnosis to death from any cause or last follow-up. Descriptive statistics were used to summarize patient characteristics, treatment exposure, and clinical outcomes.
Results/Description/Main Outcome Measure(s):
Seven patients with HIV-associated plasmablastic lymphoma were identified. Median age at diagnosis was 32 years (range, 28-44), and five patients (71%) were male. All patients had documented HIV infection at the time of diagnosis. Advanced-stage disease was common, with Ann Arbor stage IV observed in six patients (86%) and stage III in one patient (14%). Immunophenotypic findings were consistent with plasmablastic differentiation and were characterized by high proliferative indices.
All patients received intensive frontline therapy based on EPOCH chemotherapy. Five patients (71%) were treated with daratumumab-EPOCH, one patient (14%) received EPOCH alone, and one patient (14%) received bortezomib-EPOCH. Among evaluable patients, one achieved a complete response and one achieved a partial response following frontline treatment.
After a median follow-up of approximately 18 months, four patients (57%) remained alive, while three patients (43%) had died. Durable survival was observed in a subset of patients treated with daratumumab-containing regimens despite the advanced stage of disease at presentation.
Conclusion(s).: Plasmablastic lymphoma remains a rare and highly aggressive lymphoma that predominantly affects young patients living with HIV and frequently presents with advanced-stage disease. In this single-center experience, daratumumab-containing EPOCH-based regimens were the most commonly used frontline approach and demonstrated encouraging clinical activity in a population traditionally associated with poor outcomes. Although limited by the small sample size inherent to this uncommon entity, prolonged survival was observed in a subset of patients. These findings support the continued investigation of anti-CD38-based strategies and highlight the need for multicenter collaborative studies to optimize treatment and improve outcomes in HIV-associated plasmablastic lymphoma.
Trademarked Items:
References:
