Literature DB >> 28926410

Outcomes for HIV-associated diffuse large B-cell lymphoma in the modern combined antiretroviral therapy era.

Caroline Besson1, Remi Lancar, Sophie Prevot, Michele Algarte-Genin, Pierre Delobel, Fabrice Bonnet, Marie-Caroline Meyohas, Marialuisa Partisani, Lucie Oberic, Jean Gabarre, Cécile Goujard, François Boue, Paul Coppo, Regis Costello, Houria Hendel-Chavez, Nawel Mekerri, Gabriella Dos Santos, Christian Recher, Richard Delarue, Rene-Olivier Casasnovas, Yassine Taoufik, Nicolas Mounier, Dominique Costagliola.   

Abstract

OBJECTIVE: Non-Hodgkin's lymphoma (NHL) remains among the most frequent malignancies in persons living with HIV (PLWHIV). Survival among patients with HIV-associated diffuse large B-cell lymphoma (DLBCL), the most frequent NHL subtype, has improved markedly in recent years. We aimed to analyze characteristics and outcomes of DLBCL in HIV-infected patients in the era of modern combined antiretroviral therapy (cART).
DESIGN: PLWHIV with lymphoma were prospectively enrolled in the French ANRS-CO16 Lymphovir cohort between 2008 and 2015. We compared the patients treated with R-CHOP) (rituximab, cyclophosphamide, daunorubicin, vin-cristine, prednisolone) with HIV-negative DLBCL patients enrolled simultaneously in the R-CHOP arms of Lymphoma Study Association trials.
RESULTS: Among 110 PLWHIV with NHL, 52 (47%) had systemic DLBCL. These 52 cases had frequent extranodal disease (81%), poor performance status (35%) and advanced age-adjusted international prognostic index (aaIPI) (58%), and were mainly treated with R-CHOP (n = 44, 85%). Their median CD4 T-cell count was 233 cells/μl, and 79% of patients were on cART. The 2-year overall and progression-free survival rates were both 75% (95% confidence interval: 64%, 88%). Factors associated with progression or death in univariate analysis were poor performance status [hazard ratio: 3.3 (1.2, 8.9)], more than one extranodal site [hazard ratio: 3.4 (1.1, 10.5)] and an advanced aaIPI [hazard ratio: 3.7 (1.0, 13.1)]. Progression-free survival after R-CHOP therapy did not differ from that of the HIV-negative counterparts (P = 0.11).
CONCLUSION: In the recent cART era, despite frequent high-risk features, the 2-year overall survival of HIV-DLBCL patients reaches 75%. Outcomes after R-CHOP therapy are similar to those of HIV-negative patients with similar aaIPI.

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Year:  2017        PMID: 28926410     DOI: 10.1097/QAD.0000000000001652

Source DB:  PubMed          Journal:  AIDS        ISSN: 0269-9370            Impact factor:   4.177


  17 in total

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5.  Clinical characteristics and outcomes in HIV-associated diffuse large B-cell lymphoma in China: A retrospective single-center study.

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Review 6.  HIV Lymphoma and Burkitts Lymphoma.

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7.  Cardiac Involvement by HIV-Associated DLBCL.

Authors:  Charles T Mupamombe; Jude Noel; Derek B Laskar; Liza Valdivia
Journal:  Case Rep Med       Date:  2018-07-24

8.  The determinants and impact of diagnostic delay in lymphoma in a TB and HIV endemic setting.

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9.  Survival and consolidative radiotherapy in patients living with HIV and treated for diffuse large B-cell lymphoma.

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10.  Prevalence of HIV in Patients with Malignancy and of Malignancy in HIV Patients in a Tertiary Care Center from North India.

Authors:  Sanjeev Sinha; Ashish Agarwal; Kartik Gupta; Dibyakanti Mandal; Mitul Jain; Roger Detels; Karabi Nandy; Michelle A DeVos; S K Sharma; N Manoharan; P K Julka; G K Rath; Richard F Ambinder; Ronald T Mitsuyasu
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