Chao, C, Xu, L, Abrams, D, Leyden, W, Horberg, M, Towner, W et al.. Survival of non-Hodgkin lymphoma patients with and without HIV infection in the era of combined antiretroviral therapy. AIDS 24: 1765-1770

Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California 91101, USA.
AIDS (London, England) (Impact Factor: 5.55). 05/2010; 24(11):1765-70. DOI: 10.1097/QAD.0b013e32833a0961
Source: PubMed


To investigate the survival outcomes for non-Hodgkin lymphoma (NHL) in HIV-infected vs. uninfected patients from the same integrated healthcare system, and to identify prognostic factors for HIV-related NHL in the era of combined antiretroviral therapy.
A cohort study.
Incident NHL diagnosed between 1996 and 2005 were identified from members of Kaiser Permanente California Health Plans. Two-year all-cause and lymphoma-specific mortality by HIV status were examined using multivariable Poisson regression. Among HIV-infected patients, prognostic factors of demographics, lymphoma, and HIV-related characteristics for the same outcomes were also examined.
A total of 259 HIV-infected and 8230 HIV-uninfected incident NHL patients were evaluated. Fifty-nine percent of HIV-infected patients died within 2 years after NHL diagnosis as compared with 30% of HIV-uninfected patients. HIV status was independently associated with a doubling of 2-year all-cause mortality (relative risk = 2.0, 95% confidence interval 1.7-2.3). This elevated mortality risk for HIV-infected patients was similar for all race groups, lymphoma stages, and histologic subtypes. HIV-infected patients with CD4 cell count below 200 cells/microl, prior AIDS-defining illness, or both were also at increased risk for lymphoma-specific mortality as compared with HIV-uninfected patients. Among HIV-infected NHL patients, significant prognostic factors for overall mortality included prior AIDS-defining illness and Burkitt's subtype.
HIV-infected patients with NHL in the combined antiretroviral therapy era continue to endure substantially higher mortality compared with HIV-uninfected patients with NHL. Better management and therapeutic approaches to extend survival time for HIV-related NHL are needed.

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Available from: William Towner, Dec 10, 2014
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    • "found that IPI was a good predictor for NHL also in HIV setting, and low or low-intermediate IPI scores and CD4 cell counts >100 cells/lL were also good predictive factors [3]. Chao et al. [1] reported that lymphoma histological subtype, prior AIDS-defining illness and CD4 cell count <200 cells/lL were prognostic factors for all cause mortality among HIV patients. "
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    • "In the series reported by Galicier et al ( 2007 ) , using the LMB86 regimen , 70% of 63 HIV - infected patients with Murphy Stage IV disease achieved a CR and the estimated OS at 2 years was 47% . A comparison of BL patients treated in California suggested that the relative mortality rate at 2 years was 1AE3 ( 1AE0 – 1AE7 ) in HIV - infected compared to non - infected individ - uals ( Chao et al , 2010 ) . The successful use of DA - EPOCH in 39 newly diagnosed patients with AIDS - related lymphomas has been reported ( Little et al , 2003 ) ; seven had BL and three survived . "
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