HIV-infection impact on clinical–biological features and outcome of diffuse large B-cell lymphoma treated with R-CHOP in the combination antiretroviral therapy era

Abstract

In the cART era, HIV-related DLBCL still presents more aggressive features than HIV-unrelated DLBCL, and has a worse OS despite having a similar DFS. Prevention of HIV-related complications is essential to achieve outcomes comparable with HIV-uninfected patients with DLBCL.

Mature outcomes and prognostic indices in diffuse large B‐cell lymphoma in Malawi: a prospective cohort

“…We did not identify a difference in outcomes between HIV‐infected and HIV‐uninfected individuals, similar to most recent reports from resource‐rich countries (Navarro et al , ; Coutinho et al , ; Baptista et al , ; Besson et al , ). Of interest, being on ART prior to DLBCL diagnosis and longer duration of HIV diagnosis were associated with increased mortality in our cohort, even after adjusting for other important baseline characteristics.…”

Population‐based outcome analysis of diffuse large B‐cell lymphoma in people living with HIV infection and competent individuals

“…The comparison of outcome displayed similar long‐term OS and PFS, despite a higher proportion of treatment and lymphoma‐related early events in the AR‐DLBCL. These results of our population‐based cohort of AR‐DLBCL patients compared favourably to the results reported in AR‐DLBCL patients enrolled in clinical trials or treated in academic or referral centers . Thus, our data clearly support the current guidelines that HIV‐infected persons on ART with DLBCL should receive the same therapeutic approach as IC individuals .…”

“…Based on these premises, this is a population‐based study representing a real‐life picture of the phenomenon. As expected, AR‐DLBCL cases presented with younger age, and male predominance. Like other major published series, only one third of the SHCS patients had a diagnosis of AIDS prior to the diagnosis of DLBCL and the majority of patients was on ART.…”

“…As expected, AR‐DLBCL cases presented with younger age, and male predominance. Like other major published series, only one third of the SHCS patients had a diagnosis of AIDS prior to the diagnosis of DLBCL and the majority of patients was on ART. Nevertheless, HIV‐infected patients more frequently presented B‐symptoms and impaired PS, but despite the higher proportion of advanced stage disease, the distribution among the IPI risk groups was not significantly different compared with the IC‐DLBCL.…”

“…Clinically, whilst the standard therapy for DLBCL in IC patients (IC‐DLBCL) is chemotherapy combined with rituximab, there are still open issues in the management of AR‐DLBCL, mainly regarding the optimal chemotherapy programs and the utility of rituximab . Moreover, there are conflicting data on the outcome of AR‐DLBCL patients when compared with IC‐DLBCL . The present study was designed to allow the comparison of a series of consecutive AR‐DLBCL patients from the Swiss HIV Cohort Study (SHCS) and a series of consecutive IC‐DLBCL patients from 2 centres in Switzerland and Northern Italy.…”