Lymphomas
Contributions
Type: Publication Only
Background
AIDS-related lymphomas (ARL) are frequent complication of HIV infection, due to progressive CD4+ T-lymphocytes depletion and subsequent immune impairment. HIV-positive patients (pts) have up to 200-fold increased incidence for non-Hodgkin lymphomas (NHLs). Most ARLs are aggressive forms of B-NHLs. Usually pts presents with advanced disease, and prognosis is generally poor. Previous studies reported International prognostic Index score (IPI) ≤2 as significant predictive factor for overall survival (OS). Current standard in ARL patient’s treatment is concomitant combined antiretroviral therapy (ART) and chemotherapy.
Aims
The aims of this study were to detect prognostic factors and estimate benefit of concomitant ART and chemotherapy for ARL patients OS.
Methods
We enrolled 37 ARL patients in our study. All were treated at the Clinical Centre of Serbia, Belgrade in period 2004-2014. Thirty-two pts had an aggressive NHL. Indolent NHL and Hodgkin disease were diagnosed in 2 cases each, unclassified lymphoma in 1 case. Concomitant ART (same in all cases) and chemotherapy was applied in 30 cases, chemotherapy only in 4, neither ART nor chemotherapy in 3 cases.
Results
We found that use of concomitant ART and chemotherapy (p= .009, DF=1), IPI risk score ≤2 (p= .031, DF=1) and LDH level ≤400IU (p= .028, DF=1) were significant for OS (10 months, 2-102). Same parameters were confirmed as positive OS predictors in univariate survival analysis (p= .020, 95.0%CI for RR 0.141-0.847; p=.046, RR 1.013-4.813; p= .097, RR 0.875-4.25 respectively). In multivariate analysis concomitant ART and chemotherapy remained significant for OS (p= .012, RR 0.120-0.774).
Summary
Our results suggested necessity for prompt use of concomitant ART and chemotherapy in ARL treatment, in order to improve OS. Most ARLs are very aggressive, both in terms of histology and clinical course, but pts without advanced disease seems to have better OS rate when treated this way.
Keyword(s): AIDS/HIV, Chemotherapy, Lymphoma
Session topic: Publication Only
Type: Publication Only
Background
AIDS-related lymphomas (ARL) are frequent complication of HIV infection, due to progressive CD4+ T-lymphocytes depletion and subsequent immune impairment. HIV-positive patients (pts) have up to 200-fold increased incidence for non-Hodgkin lymphomas (NHLs). Most ARLs are aggressive forms of B-NHLs. Usually pts presents with advanced disease, and prognosis is generally poor. Previous studies reported International prognostic Index score (IPI) ≤2 as significant predictive factor for overall survival (OS). Current standard in ARL patient’s treatment is concomitant combined antiretroviral therapy (ART) and chemotherapy.
Aims
The aims of this study were to detect prognostic factors and estimate benefit of concomitant ART and chemotherapy for ARL patients OS.
Methods
We enrolled 37 ARL patients in our study. All were treated at the Clinical Centre of Serbia, Belgrade in period 2004-2014. Thirty-two pts had an aggressive NHL. Indolent NHL and Hodgkin disease were diagnosed in 2 cases each, unclassified lymphoma in 1 case. Concomitant ART (same in all cases) and chemotherapy was applied in 30 cases, chemotherapy only in 4, neither ART nor chemotherapy in 3 cases.
Results
We found that use of concomitant ART and chemotherapy (p= .009, DF=1), IPI risk score ≤2 (p= .031, DF=1) and LDH level ≤400IU (p= .028, DF=1) were significant for OS (10 months, 2-102). Same parameters were confirmed as positive OS predictors in univariate survival analysis (p= .020, 95.0%CI for RR 0.141-0.847; p=.046, RR 1.013-4.813; p= .097, RR 0.875-4.25 respectively). In multivariate analysis concomitant ART and chemotherapy remained significant for OS (p= .012, RR 0.120-0.774).
Summary
Our results suggested necessity for prompt use of concomitant ART and chemotherapy in ARL treatment, in order to improve OS. Most ARLs are very aggressive, both in terms of histology and clinical course, but pts without advanced disease seems to have better OS rate when treated this way.
Keyword(s): AIDS/HIV, Chemotherapy, Lymphoma
Session topic: Publication Only