J Cancer Res Clin Oncol 2012; 138: 425–430. 127 González-Molleda L, Wang Y, Yuan Y. Potent antiviral activity of topoisomerase I and Quizartinib II inhibitors against Kaposi’s sarcoma-associated herpesvirus. Antimicrob Agents Chemother 2012; 56: 893–902.

128 Davies BR, Logie A, McKay JS et al. AZD6244 (ARRY-142886), a potent inhibitor of mitogen-activated protein kinase/extracellular signal-regulated kinase kinase 1/2 kinases: mechanism of action in vivo, pharmacokinetic/pharmacodynamic relationship, and potential for combination in preclinical models. Mol Cancer Ther 2007; 6: 2209–2219. People living with HIV have an increased risk of developing non-Hodgkin lymphoma (NHL) [1–4]. The two commonest subtypes are diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma/leukaemia Sotrastaurin concentration (BL), which are considered AIDS-defining illnesses (ADI). NHL is the second most common tumour in individuals with HIV and although studies show a decline in incidence since the introduction of HAART [5–8], AIDS-related lymphomas (ARLs)

have increased as a percentage of first ADI [9,10]. The development of ARL has been shown to be related to older age, low CD4 cell count and no prior treatment with HAART [11]. Patients tend to present with advanced clinical stage, B symptoms and extranodal involvement, including bone marrow. Before the introduction of HAART, the outlook for patients with ARL was poor, with the median survival for patients treated with chemotherapy being around 2–13 months. Median survival in the post-HAART era is beginning to approach that observed in the HIV-negative population and depends critically on histological subtype and stage of disease

[12–20]. The diagnosis of ARL should be based on a tissue biopsy rather than a cytological sample. In addition to the routine investigations advised as part of HIV clinical care, all patients require staging with clinical evaluation, blood tests, computerized tomography (CT) scanning and bone Sclareol marrow aspiration and trephine (Table 4.1). 18fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET) scanning at diagnosis improves the staging accuracy and the Imaging Subcommittee of the International Harmonisation Project in Lymphoma has produced guidelines strongly recommending a baseline pretreatment 18F-FDG PET scan [21]. Cerebrospinal fluid (CSF) examination is recommended if there are clinical signs of central nervous system (CNS) disease, or paranasal sinus, breast, epidural or testicular involvement. Cytological assessment by cytospin and flow cytometry is recommended [22]. Indications for intrathecal prophylaxis will be outlined in BCSH guidelines and should be administered at time of first CSF examination in these patients.