Changes in the influence of lymphoma- and HIV-specific factors on outcomes in AIDS-related non-Hodgkin lymphoma

Barta, Stefan K.; Samuel, Merna; Xue, Xiaonan; Wang, D.; Lee, J. Y.; Mounier, Nicolas; Ribera, Josep‐Marǐa; Spina, Michele; Tirelli, Umberto; Ra, Weiss; Galicier, Lionel; Boué, François; Little, Richard F.; Dunleavy, Kieron; Wilson, Wyndham H.; Wyen, Christoph; Remick, Scot C.; Kaplan, Lawrence D.; Ratner, Lee; Noy, Ariela; Sparano, Joseph A.

doi:10.1093/annonc/mdv036

Cited by 92 publications

(76 citation statements)

References 27 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Delayed introduction of cART has been shown to significantly increase the risk of developing ARL [10]. Furthermore, a significant improvement in complete remission (CR) rates and survival for all patients with ARL receiving cART has been demonstrated [11].…”

Section: Chemotherapy and Cartmentioning

confidence: 99%

HIV-Associated Malignant Lymphoma

et al. 2017

View full text Add to dashboard Cite

Acquired immune deficiency syndrome (AIDS)-related lymphomas (ARL) still represent a relevant field of clinical research. For most histological subtypes of ARL, no optimal initial therapy has been clearly defined so far. Rituximab plus chemotherapy is feasible and effective and should be offered to all patients with CD20-positive ARL regardless of their CD4 cell count. Combination antiretroviral therapy (cART) should be given concomitantly with chemotherapy, bearing in mind potential drug-drug interactions. Appropriate treatment of ARL is determined by a number of factors such as lymphoma stage, performance status, comorbidities, histological subtype, and immunosuppression. Treatment should principally be the same as in human immunodeficiency virus (HIV)-negative lymphoma patients. In HIV-related Hodgkin's lymphoma, high cure rates have been achieved with stage-adapted treatment approaches, albeit with worse outcomes compared to immunocompetent patients.

show abstract

Section: Chemotherapy and Cartmentioning

confidence: 99%

HIV-Associated Malignant Lymphoma

et al. 2017

View full text Add to dashboard Cite

show abstract

“…(Bohlius, et al 2009, Dunleavy, et al 2010, Little, et al 2001) Additionally, cART permitted patients with ARL to be treated more aggressively, thereby allowing significantly improved outcomes. (Barta, et al 2015, Gopal, et al 2013)…”

Section: Introductionmentioning

confidence: 99%

Central nervous system involvement in AIDS‐related lymphomas

et al. 2016

View full text Add to dashboard Cite

Summary Central nervous system (CNS) involvement is reportedly more common in acquired immunodeficiency syndrome (AIDS)-related lymphomas (ARL). We describe factors and outcomes associated with CNS involvement at baseline (CNSB) and relapse (CNSR) in 886 patients with newly diagnosed ARL. Of 886 patients, 800 received either intrathecal (IT) therapy for CNSB or IT prophylaxis. CNSB was found in 13%. CNSB was not associated with reduced overall survival (OS). There was no difference in the prevalence of CNSB between the pre-combination antiretroviral therapy (cART) and cART eras. 5.3% of patients experienced CNSR at a median of 4.2 months after diagnosis (12% if CNSB; 4% if not). Median OS after CNSR was 1.6 months. On multivariate analysis, only CNSB (hazard ratio [HR] 3.68, p=0.005) and complete response to initial therapy (HR 0.14, p<0.0001) were significantly associated with CNSR. When restricted to patients without CNSB, IT CNS prophylaxis with 3 versus 1 agent did not significantly impact the risk of CNSR. Despite IT CNS prophylaxis, 5% of patients experienced CNSR. Our data confirms that CNSR in ARL occurs early and has a poor outcome. Complete response to initial therapy was associated with a reduced frequency of CNSR. Although CNSB conferred an increased risk for CNSR, it did not impact OS.

show abstract

“…As demonstrated in the HIV-autologous transplant trial mentioned above (4), those with HIV and cancer who undergo intensive therapy have similar outcomes to the background population. Multiple other studies and retrospective analyses show this to be the case in diffuse large B-cell lymphoma, classical Hodgkin lymphoma (cHL), and Burkitt lymphoma (10). Therefore, inclusion of those with HIV who are relatively healthy from the HIV perspective onto clinical trials who are otherwise eligible for the trial should be adopted as the contemporary standard.…”

Section: Is There Any Utility To Including Persons With Hiv Onto Cancmentioning

confidence: 93%

Cancer clinical trials in persons with HIV infection

Little¹

2017

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

Purpose of the review The era of modern HIV therapeutics is well under way. The cancer and infectious disease epidemiology of HIV disease has markedly altered as populations are availed to the benefits of antiretroviral therapy (ARV). The types of cancers occurring among those with HIV infection has broadened but the case burden in absolute numbers is very low relative to the background population. There are fewer incident cases of the AIDS-defining cancers (aggressive B-cell lymphomas, Kaposi’s sarcoma, cervical cancer). There is an increased risk for certain non-AIDS-defining cancers, but these occur somewhat sporadically relative to clinical trial enrollment. The changing epidemiology of cancer in HIV poses challenges as well as opportunities for participation of persons with HIV in cancer therapy clinical trials. Recent Findings There are a excellent examples of cancer trials that inform cancer therapy for patients with HIV infection. Examples include those from HIV-specific trials and from trials mainly focused on the background population that included patients with HIV infection. Summary Interpretation of clinical trials to guide therapy for those with HIV infection and cancer largely depends on data that does not include HIV infected patients. The ability to extend clinical trials findings to populations not included in clinical trials remains problematic for a variety of populations, including those with HIV or AIDS. Careful prioritization of studies designed to bridge this gap is needed. However, there are published studies that serve as excellent examples bridging these gaps and the portfolio of cancer therapy trials underway will inform HIV and cancer better than at any time in the past.

show abstract

Changes in the influence of lymphoma- and HIV-specific factors on outcomes in AIDS-related non-Hodgkin lymphoma

Cited by 92 publications

References 27 publications

HIV-Associated Malignant Lymphoma

HIV-Associated Malignant Lymphoma

Central nervous system involvement in AIDS‐related lymphomas

Cancer clinical trials in persons with HIV infection

Contact Info

Product

Resources

About