Prognostic factors for advanced‐stage human immunodeficiency virus‐associated classical Hodgkin lymphoma treated with doxorubicin, bleomycin, vinblastine, and dacarbazine plus combined antiretroviral therapy: A multi‐institutional retrospective study

Castillo, Jorge J.; Bower, Mark; Brühlmann, Jérémy; Novak, Urban; Furrer, Hansjakob; Tanaka, Paula Yurie; Besson, Caroline; Montoto, Silvia; Cwynarski, Kate; Abramson, Jeremy S.; Dalia, Samir; Bibas, Michele; Connors, Joseph M.; Furman, Michael; Nguyen, Minh Ly; Cooley, Timothy P.; Beltrán, Brady E; Collins, Jaime A.; Vose, Julie M.; Xicoy, Blanca; Ribera, Josep‐Marǐa

doi:10.1002/cncr.29066

Cited by 36 publications

(30 citation statements)

References 28 publications

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“…The majority (72.34%) of the patients included in the study had never received ART prior to their lymphoma treatment. This finding is in contrast to European studies in which the majority of patients are ART-exposed [ 12 – 17 ]. The fact that all patients who received ART before the diagnosis of NHL came from the capital could imply that people living in remote rural areas are less likely to receive ART.…”

Section: Discussioncontrasting

confidence: 94%

“…Five-year survival in HIV-infected patients diagnosed with systemic NHL was low compared to European cohort studies [ 12 , 18 ], but similar to other Latin American studies [ 19 , 20 ]. Although the difference in survival between NHL patients with and without HIV is generally felt to be improving, we see that the OS in developing countries like Peru continues to lag [ 10 , 19 ].…”

Section: Discussionsupporting

confidence: 80%

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Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience

Cuéllar

Anampa-Guzmán

Holguín

et al. 2018

Infect Agents Cancer

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BackgroundNon-Hodgkin lymphoma (NHL) is the most common cancer in people with HIV. Although 95% of HIV patients are in developing countries like Peru, the majority of these studies have been conducted in developed countries. In this study we aim to evaluate prognostic factors associated with outcomes in HIV positive patients undergoing systemic therapy for treatment of NHL.MethodsThis retrospective study includes patients with NHL seen in the Instituto Nacional de Enfermedades Neoplasicas (INEN) between 2004 to 2014. Patients were divided into two groups: antiretroviral therapy (ART) -naïve (n = 34) and those previously treated, ART-exposed (n = 13), at the time of diagnosis. All patients received chemotherapy and ART. The medical records were reviewed. Data were analyzed using t-test and chi-square test. Survival curves were estimated by the Kaplan-Meier method and comparison was done by log-rank test. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model.ResultsAll ART-exposed patients were from the capital city (p = 0.039); they had significantly lower hemoglobin levels compared to ART-naïve patients (p = 0.026). The median OS was 47.7 months with a 5-yr OS of 36.1%. The median OS for ART naïve patients was significantly higher than that for ART-exposed patients (57.05 and 21.09 months, respectively; p = 0.018). Advanced stage and low serum albumin were associated with lower OS in both groups. Age > 60 was associated with worse outcomes in the ART-naïve cohort.ConclusionsAdvanced stage, low serum albumin and previous ART treatment were the primary prognostic factors associated with poorer outcomes in patients with NHL and HIV infection. In ART-naïve patients, age > 60 was associated with worse outcomes but in this cohort, older patients still had better overall outcomes than ART-exposed patients.

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Section: Discussioncontrasting

confidence: 94%

Section: Discussionsupporting

confidence: 80%

Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience

Cuéllar

Anampa-Guzmán

Holguín

et al. 2018

Infect Agents Cancer

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“…Considering the dramatic health threats by sexually transmitted co-infections posing to people living with HIV/AIDS in recent years, the current study suggested surveillance drug resistance mutations (SDRMs) as a national surveillance system which was largely consistent with our suggestion[ 24 ]. Other studies further emphasize the association between TDR and HIV subtype among HIV infected MSM, which may be meaningful for STI control[ 25 ],[ 26 ],[ 27 ],[ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with sexually transmitted infections among HIV infected men who have sex with men

Xian

Zhu

Zhang³

et al. 2017

PLoS ONE

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To investigate the factors associated with sexually transmitted infection and Human Immunodeficiency Virus (STI-HIV) co-infection among men who have sex with men (MSM). A total of 357 HIV-infected participants (84 STI-HIV co-infection and 273 HIV infections only) were recruited from Jiangsu, China. Logistic regression analyses were used to estimate the related factors associated with STI-HIV co-infection. Marginal structural models were adopted to estimate the effect of transmission drug resistance (TDR) on STI-HIV co-infection. For all participants, logistic regression analyses revealed that those who diagnosed with HIV-1 for longer duration (≥1.8 years) were significantly associated with reduced STI-HIV co-infection risk (OR = 0.55, 95%CI: 0.32–0.96, P = 0.036). In further stratification analysis by antiretroviral therapy (ART), individuals with longer duration showed consistent significant associations with STI-HIV co-infection risk (OR = 0.46, 95%CI: 0.26–0.83, P = 0.010) among MSM with ART-naïve status. In addition, significant reduced risk for STI-HIV co-infection (OR = 0.98, 95%CI: 0.96–0.99, P = 0.010) were observed in younger (under the average age of 31.03) MSM of the same group. Interestingly, we also found TDR was significantly associated with an increased risk of STI-HIV co-infection risk (OR = 3.84, 95%CI: 1.05–14.03, P = 0.042) in ART-naïve group. Our study highlights a pattern of STI-HIV co-infection among MSM in China and indicates that targeted interventions aimed at encouraging TDR monitoring in MSM with early HIV infection are warranted.

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“…With appropriate supportive care, standard regimens such as ABVD or BEACOPP can be delivered. [39–42] The results of the largest studies are shown in Table 4 [40,42–45]. Greater than normal toxicity must be anticipated and can be partially mitigated by use of G-CSF and sometimes erythropoietin for drug-induced anemia.…”

Section: Treatment Of Hodgkin Lymphoma Patients With Coincident Himentioning

confidence: 99%

“…In a recent large multi-institutional, retrospective study of 229 patients with HIV-associated, advanced-stage, classical HL, patients received ABVD plus combination antiretroviral therapy [46]. Five-year PFS and overall survival rates were 69% and 78%, respectively.…”

Section: Treatment Of Hodgkin Lymphoma Patients With Coincident Himentioning

confidence: 99%

Hodgkin lymphoma in the elderly, pregnant, and HIV-infected

Bachanová

Connors

2016

Seminars in Hematology

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Hodgkin lymphoma (HL) presenting in patients with co-incidental advanced age, pregnancy, or human immunodeficiency virus (HIV) infection is uniquely challenging to manage. In this article we integrate recent evidence and clinical expertise to present recommendations for diagnosis and therapeutic management. Older patients with HL need to be carefully evaluated for comorbidies after which judicious choice of chemotherapy should minimize functional compromise. A pregnant patient with concurrent HL should be staged with minimal use of imaging requiring ionizing radiation and treated in an individualized manner optimally combining the strategies of treatment deferral when appropriate, use of single-agent vinblastine for symptomatic disease and reservation of multi-agent chemotherapy for the small minority of patients with aggressive clinical presentation. Treatment of HL coincident with HIV infection requires a combination of highly active anti-retroviral agents (HAART), standard multi-agent chemotherapy with meticulous attention to drug–drug interactions, and vigorous supportive care to ensure the best chance of cure.

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Prognostic factors for advanced‐stage human immunodeficiency virus‐associated classical Hodgkin lymphoma treated with doxorubicin, bleomycin, vinblastine, and dacarbazine plus combined antiretroviral therapy: A multi‐institutional retrospective study

Cited by 36 publications

References 28 publications

Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience

Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience

Risk factors associated with sexually transmitted infections among HIV infected men who have sex with men

Hodgkin lymphoma in the elderly, pregnant, and HIV-infected

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