Clinical Characteristics and Survival Outcomes of Primary Effusion Lymphoma: A National Cancer Database Study |
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| Institution: | 1. Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH;2. Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL;3. Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH;1. Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA;2. Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA;3. Department of Hematology & Oncology, Thomas Jefferson University, Philadelphia, PA;4. Dermatology Specialists of Alabama, Madison, AL;1. Lombardi Comprehensive Cancer Center and MedStar Georgetown University Hospital, Washington, DC;2. Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC;3. Department of Internal Medicine, Rush University Medical Center, Chicago, IL;4. Center for Biostatistics, Informatics and Data Science, MedStar Health Research Institute, Hyattsville, MD;5. Division of Pulmonary, Critical Care, and Sleep Medicine, MedStar Georgetown University Hospital, Washington, DC;1. Stony Brook University Hospital Cancer Center, Stony Brook, NY;2. Amsterdam UMC, Vrije Universiteit, Cancer Center, Amsterdam, Netherlands;3. Hématologie Clinique and INSERM 1231, Dijon, France;4. LUMC, Leiden, Netherlands;5. University of Liverpool, Liverpool, United Kingdom;6. Hackensack University Medical Center, Hackensack, NJ, United States;7. Hôpital Pitié Salpêtrière, Paris, France;8. Cliniques Universitaires Saint-Luc, Brussels, Belgium;9. Cleveland Clinic, Cleveland, OH, United States;10. APHP, Saint-Louis Hospital, Hemato-oncology, Paris, France & Diderot University, Paris, France;11. University of Torino, Turin, Italy;12. Hospital Universitario Virgen del Rocio, Sevilla, Spain;13. Princess Margaret Cancer Centre, Toronto, Canada;14. St. Vincent''s Hospital Sydney, Darlinghurst, Australia;15. Medical University of Vienna, Vienna, Austria;16. UH Seidman Cancer Center, Cleveland, OH, United States;17. Rabin MC, Petah Tiqwa, Israel;18. Instytut Hematologii i Transfuzjologii, Warszawa, Poland;19. Dr. B. R. A. Institute Rotary Cancer Hospital, New Delhi, India;20. Hospital Universitari Germans Trias I Pujol, Barcelona, Spain;21. Addenbrooke''s Hospital, Cambridge, United Kingdom;22. Teaching Hospital Mór Kaposi, Kaposvár, Hungary;23. UZ Gent, Gent, Belgium;24. Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece;25. Institute of Medical Sciences & SUM Hospital, Odisha, India;26. St.Vincent''s Hospital Melbourne, Fitzroy, Australia;27. Karyopharm Therapeutics, Newton, MA, United States;28. Hospital Universitario La Paz, Madrid, Spain;29. Institut Jules Bordet, Brussels, Belgium;1. Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy;2. Pathology Unit, AOUC Policlinico, Bari, Italy;3. Clinical Pathology Unit, AOUC Policlinico, Bari, Italy;1. Department of Hematology, Nagano Red Cross Hospital, Nagano City, Nagano, Japan;2. Department of Pathology, Nagano Red Cross Hospital, Nagano City, Nagano, Japan;1. Miami Cancer Institute, Miami, FL;2. Baptist Health South Florida, Miami, FL |
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| Abstract: | IntroductionPrimary effusion lymphoma (PEL) is a rare HHV8(+) non–Hodgkin lymphoma associated with HIV infection or other causes of immunosuppression. Large-scale studies describing the natural history of this entity are lacking.Materials and MethodsNational cancer database (NCDB) was queried for patients diagnosed with PEL between 2004 and 2016. All patients age ≥ 18 years diagnosed with PEL were included. We excluded patients with multiple primary malignancies or lost follow-up. Kaplan-Meier and multivariate cox regression were used in the analyses.ResultsOf the 219 PEL patients included in the analysis, 179 (82%) were males, 161 (74%) Caucasian and 49 (22%) African American. Median age at diagnosis was 60 ± 19 years and median OS (mOS) was 8.5 months. One hundred and fifteen were HIV+, 63 HIV-, 111 received chemotherapy, and 101 did not. Patients who received chemotherapy had better mOS compared to patients who did not receive chemotherapy (13 vs. 3 months, P < .001). This difference was observed in HIV+ patients (22.97 vs. 1.97 months, P = .006), but not in HIV- patients (6.24 vs. 8.20 months, P = .752). On multivariate analysis, chemotherapy treatment was associated with better OS (HR 0.502 95% CI 0.324-0.777; P = .002), whereas HIV status did not affect the OS (HR 0.6 95% CI 0.3-1.4; P = .258).ConclusionThis largest retrospective analysis on PEL revealed that current chemotherapeutic approach is significantly beneficial for HIV+ patients but not for HIV- patients. The rapid advancement in HIV treatment might be playing a role in survival improvement among HIV+ patients. Novel therapies are needed to improve the survival of patients with PEL, especially in HIV- patients.MicroabstractPEL is a rare HHV8(+) non–Hodgkin lymphoma. Using national cancer database, we studied clinical characteristics, and outcomes of 219 PEL patients. We found that chemotherapy significantly improved overall survival in HIV+ patients. However, a similar survival improvement was not seen in HIV- patients. Significant improvement in efficacy of antiretroviral therapy is likely contributing to the survival improvement in HIV+ patients. |
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| Keywords: | Time-To-Treat |
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