Patients With Malignant Lymphoma and HIV Infection Experiencing Remission After First-Line Treatment Have an Excellent Prognosis |
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Authors: | Katharina Kriegsmann Julia S Klee Manfred Hensel Eike C Buss Mark Kriegsmann Martin Cremer Anthony D Ho Gerlinde Egerer Patrick Wuchter Mathias Witzens-Harig |
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Institution: | 1. Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany;2. Institute of Pathology, Heidelberg University, Heidelberg, Germany;3. Mannheimer Onkologie Praxis, Mannheim, Germany;4. Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany |
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Abstract: | BackgroundMalignant lymphoma is still the leading cause of death among AIDS-related diseases.Patients and MethodsWe performed a retrospective analysis of 50 HIV-positive lymphoma patients. The median interval between HIV and malignant lymphoma diagnosis was 4 years. Eight patients (16%) had Hodgkin lymphoma and 42 (84%) non-Hodgkin lymphoma. Among non-Hodgkin lymphoma patients, diffuse large B-cell lymphoma (n = 18, 42%), Burkitt lymphoma (n = 11, 26%), and plasmoblastic lymphoma (n = 5, 12%) were the most frequent entities.ResultsLymphoma was treated according to standard protocols. Forty-four patients (88%) received combination antiretroviral therapy, 2 (4%) were not treated, and in 4 (8%) the HIV treatment status was not clarified. Response to first-line therapy was complete response (CR) in 24 (56%), partial response (PR) in 15 (35%), and stable disease in 1 (2%). Three patients (7%) developed progressive disease, and 9 (18%) experienced relapse after CR or PR. At a median observation period of 31 (range, 0.4-192) months, the 1-, 2-, and 5-year overall survival was 87%, 79%, and 76%, respectively. At univariate analysis, remission status after first-line treatment was predictive of outcome, as the 2-year overall survival was 95%, 66%, and 0 for patients with CR, with PR, and with progressive disease (P < .001). Results of the multivariate analysis revealed lactate dehydrogenase concentration at lymphoma diagnosis (P = .046) and relapse (P = .050) to be independent factors for overall survival.ConclusionFirst-line treatment of lymphoma in HIV positive patients is crucial. Patients who experienced and maintained a first CR had a favorable prognosis. |
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Keywords: | Address for correspondence: Katharina Kriegsmann MBA Department of Hematology Oncology and Rheumatology Heidelberg University Im Neuenheimer Feld 410 69120 Heidelberg Germany Hodgkin lymphoma Human immunodeficiency virus Non-Hodgkin lymphoma Overall survival Progression-free survival |
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