Impact of Highly Active Antiretroviral Therapy in the Treatment of HIV–Infected Patients with Systemic Non-Hodgkin‘s Lymphoma

Abstract

Twenty cases of systemic non-Hodgkin's lymphoma (NHL) in HIV-infected patients were reviewed over a 10-year-period, divided into Group A, including 13 NHL cases treated before the highly active antiretroviral therapy (HAART) era, and Group B, including 7 patients who received HAART. A Kaplan-Meier survival curve was performed and log-rank was applied to assess statistical differences between the groups. In group A, the median CD4 count was 36 cells/mm3. No complete remission was found. In group B, the median CD4 count was 137 cells/mm3. Four patients (57.0%) are still alive and in complete remission. Group A had a median survival of 5 months and group B 31 months (p = 0.0032). Our results are in agreement with recent reports in that a higher CD4 count and better immune status achieved with HAART is predictive of a better outcome. We found that HAART in combination with chemotherapy improves overall survival of NHL patients without increasing adverse effects.

Clinical features and predictors of survival of AIDS‐related non‐Hodgkin's lymphoma in a population‐based case series in Sydney, Australia

“…Most [12–15,27,29,31], but not all [6,16–18] studies have reported improved NHL survival in the era of HAART. In a US study to 1998, there was no increase in survival in the HAART era [16], while a UK study found a nonsignificant trend ( P =0.12) towards improved survival [17].…”

“…One possible factor, suggested by other studies, is receipt of HAART after NHL diagnosis. A good immunological response to HAART after NHL diagnosis was found to predict improved survival of NHL, independent of the documented response to chemotherapy, in one observational study [11], and receipt of HAART after NHL diagnosis predicted improved survival in a multivariate model of predictors of survival in a Spanish series [13], in a series from Brazil [31], in the MACS study in the US [15] and in the French Aquitaine cohort [29]. Clinical series have demonstrated that the coincident administration of HAART and chemotherapy is safe and effective [32].…”

Survival and Prognostic Factors for AIDS and Non-AIDS Patients with Non-Hodgkin’s Lymphoma in Bahia, Brazil: A Retrospective Cohort Study

“…Currently, the life expectation of HIV-infected individuals is approaching found in the general population. However, the available information suggests that there is an increase in the frequency of malignancies among Brazilian HIV-infected patients, as observed in other countries [ 12 , 13 ]. Unfortunately, there is scarce information on the frequency of each type of cancer and on survival time for HIV-related malignancies.…”

Quimioterapia associada à terapia anti-retroviral de alta eficácia no tratamento dos linfomas não-Hodgkin agressivos relacionados à Síndrome da Imunodeficiência Adquirida

“…6,7 Em nosso país, entretanto, pouco é sabido sobre a incidência, o comportamento clínico e a sobrevida dos pacientes com linfoma e AIDS na era pós-HAART. 8 Em nosso serviço, a partir de 1996, passamos a utilizar quimioterapia em baixas doses associada a HAART em pacientes portadores de linfoma e AIDS. Neste estudo apresentamos o resultado de seis anos desta estratégia terapêutica.…”