Human immunodeficiency virus‐associated lymphomas in the antiretroviral therapy era: Analysis of the National Cancer Data Base

Abstract

Disparities in chemotherapy delivery need attention, because a majority of HIV-positive patients with NHL in the United States are now black or Hispanic. Higher volume centers were associated with an increased likelihood of chemotherapy administration. Survival gains in patients with PCNSL parallel an increase in chemotherapy use, supporting its role in therapy. [See Editorial on pages 000-000, this issue.] Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2689-2697. © 2016 American Cancer Society.

Disparities in lymphoma on the basis of race, gender, HIV status, and sexual orientation

“…Similar to studies in other malignancies, lack of treatment with chemotherapy for HIV infected patients with HL and NHL was associated with black or Hispanic race, lower socioeconomic status, and lack of insurance coverage (28). These findings are important given that the incidence of new HIV cases in the US are currently highest among blacks (27). …”

“…Prior to HAART, NHL such as DLBCL, Burkitt or Burkitt-like lymphoma (BL), primary central nervous system lymphoma (PCNSL), or rare entities that include primary effusion lymphoma (PEL) and plasmablastic lymphoma were more common than HL in HIV infected patients (27). In the era of HAART, the incidence of NHL as decreased, and the incidence of HL among HIV-infected patients has increased up to 20 folds.…”

“…In the era of HAART, the incidence of NHL as decreased, and the incidence of HL among HIV-infected patients has increased up to 20 folds. For both HL and NHL, HIV infected patients present with more advanced disease, higher IPI scores, and worse OS compared to non-HIV infected patients (27–29). Several studies have suggested that one of the major factors contributing to the differences in survival outcomes is treatment delivery (25,26,28).…”

Lymphoproliferative Disorders of the Lung

“…However, PEL has also been described in a solid form -called extracavitary PEL -that may occur as a relapse of classic PEL or as an initial presentation [164,165] . PEL is a rare lymphoma corresponding to 0.5% of all lymphoma cases and 1-8% of HIV-associated non-Hodgkin lymphoma cases [165][166][167] .…”

Human immunodeficiency virus lymphomas in the era of antiretrovirals: Is it finally time to change the discussion?

“…In their article in this issue of Cancer , Olszewski and colleagues report on trends in HIV‐associated lymphomas by analysis of the National Cancer Data Base. Not surprisingly, their findings reflect the national demographic shift in the HIV‐seropositive population, namely, the rising proportion of African Americans and Latinos who are HIV‐infected . Shockingly, a recent Centers for Disease Control and Prevention report estimates that one‐half of all African American men who have sex with men and one‐quarter of all Hispanic men who have sex with men will be diagnosed with HIV in their lifetimes .…”