HIV status does not impair the outcome of patients diagnosed with diffuse large B-cell lymphoma treated with R-CHOP in the cART era

Rita Coutinho; Alessia D. Pria; Shreyans Gandhi; Katharine Bailey; Paul Fields; Kate Cwynarski; Andrew Wilson; Panagiotis Papanastasopoulos; Melinda Tenant-Flowers; Andrew Webb; Fiona Burns; Robert Marcus; Chloe Orkin; Silvia Montoto; Mark Bower

doi:10.1097/QAD.0000000000000133

HIV status does not impair the outcome of patients diagnosed with diffuse large B-cell lymphoma treated with R-CHOP in the cART era

Rita Coutinho^*, Alessia D. Pria, Shreyans Gandhi, Katharine Bailey, Paul Fields, Kate Cwynarski, Andrew Wilson, Panagiotis Papanastasopoulos, Melinda Tenant-Flowers, Andrew Webb, Fiona Burns, Robert Marcus, Chloe Orkin, Silvia Montoto, Mark Bower

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

58 Citations (Scopus)

Abstract

Objective:

To compare the outcome of patients diagnosed with HIV infection and diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP in the cART era with that of a HIV-negative control group.

Methods:

From 2003 to 2011, 305 patients (97 HIV-positive) were diagnosed with DLBCL and treated with R-CHOP. Clinical features were compared using chi-square or Fisher's exact test. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Multivariate analysis was performed using the Cox regression proportional hazards model.

Results:

HIV-positive patients had more B symptoms and extranodal sites of disease at diagnosis, but the proportion of patients with high-intermediate/high-risk disease according to the international prognostic index (IPI) was similar between groups. Response rate was 73%, both for patients with and without HIV infection. After a median follow-up of 48 months, 30 patients relapsed after achieving a complete remission, including four HIV-positive patients. Ninety-six patients have died (19 HIV-positive), 73 of them due to DLBCL. Three patients (one HIV-positive) died due to treatment toxicity. Patients with HIV infection had a significantly longer disease-free survival (DFS) (5-year: 94 vs. 77%; P = 0.03) and overall survival (OS) (78 and 64% for HIV-positive and HIV-negative patients, respectively; P = 0.03). These results were confirmed on multivariate analysis when controlled for other potential prognostic confounders.

Conclusion:

HIV-positive patients diagnosed with DLBCL in the cART era have an excellent outcome when treated with standard immunochemotherapy. Therefore, the choice of chemotherapy in patients with lymphoma should not be influenced by HIV status.

Original language	English
Pages (from-to)	689-697
Number of pages	9
Journal	Aids
Volume	28
Issue number	5
DOIs	https://doi.org/10.1097/QAD.0000000000000133
Publication status	Published - 13 Mar 2014

Keywords

R-CHOP chemotherapy
diffuse large B-cell lymphoma
survival
prognosis
HIV
outcome
ACTIVE ANTIRETROVIRAL THERAPY
NON-HODGKIN-LYMPHOMA
AIDS-RELATED LYMPHOMA
GENE-EXPRESSION
PLUS RITUXIMAB
PHASE-II
CHEMOTHERAPY
TRIAL
SURVIVAL
RISK

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/QAD.0000000000000133

Cite this

Coutinho, R., Pria, A. D., Gandhi, S., Bailey, K., Fields, P., Cwynarski, K., Wilson, A., Papanastasopoulos, P., Tenant-Flowers, M., Webb, A., Burns, F., Marcus, R., Orkin, C., Montoto, S., & Bower, M. (2014). HIV status does not impair the outcome of patients diagnosed with diffuse large B-cell lymphoma treated with R-CHOP in the cART era. Aids, 28(5), 689-697. https://doi.org/10.1097/QAD.0000000000000133

@article{6f2be21b5c1a4c79b0f208dc4b6a3da1,

title = "HIV status does not impair the outcome of patients diagnosed with diffuse large B-cell lymphoma treated with R-CHOP in the cART era",

abstract = "Objective:To compare the outcome of patients diagnosed with HIV infection and diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP in the cART era with that of a HIV-negative control group.Methods:From 2003 to 2011, 305 patients (97 HIV-positive) were diagnosed with DLBCL and treated with R-CHOP. Clinical features were compared using chi-square or Fisher's exact test. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Multivariate analysis was performed using the Cox regression proportional hazards model.Results:HIV-positive patients had more B symptoms and extranodal sites of disease at diagnosis, but the proportion of patients with high-intermediate/high-risk disease according to the international prognostic index (IPI) was similar between groups. Response rate was 73%, both for patients with and without HIV infection. After a median follow-up of 48 months, 30 patients relapsed after achieving a complete remission, including four HIV-positive patients. Ninety-six patients have died (19 HIV-positive), 73 of them due to DLBCL. Three patients (one HIV-positive) died due to treatment toxicity. Patients with HIV infection had a significantly longer disease-free survival (DFS) (5-year: 94 vs. 77%; P = 0.03) and overall survival (OS) (78 and 64% for HIV-positive and HIV-negative patients, respectively; P = 0.03). These results were confirmed on multivariate analysis when controlled for other potential prognostic confounders.Conclusion:HIV-positive patients diagnosed with DLBCL in the cART era have an excellent outcome when treated with standard immunochemotherapy. Therefore, the choice of chemotherapy in patients with lymphoma should not be influenced by HIV status.",

keywords = "R-CHOP chemotherapy, diffuse large B-cell lymphoma, survival, prognosis, HIV, outcome, ACTIVE ANTIRETROVIRAL THERAPY, NON-HODGKIN-LYMPHOMA, AIDS-RELATED LYMPHOMA, GENE-EXPRESSION, PLUS RITUXIMAB, PHASE-II, CHEMOTHERAPY, TRIAL, SURVIVAL, RISK",

author = "Rita Coutinho and Pria, {Alessia D.} and Shreyans Gandhi and Katharine Bailey and Paul Fields and Kate Cwynarski and Andrew Wilson and Panagiotis Papanastasopoulos and Melinda Tenant-Flowers and Andrew Webb and Fiona Burns and Robert Marcus and Chloe Orkin and Silvia Montoto and Mark Bower",

year = "2014",

month = mar,

day = "13",

doi = "10.1097/QAD.0000000000000133",

language = "English",

volume = "28",

pages = "689--697",

journal = "Aids",

issn = "0269-9370",

publisher = "Lippincott Williams and Wilkins",

number = "5",

}

Coutinho, R, Pria, AD, Gandhi, S, Bailey, K, Fields, P, Cwynarski, K, Wilson, A, Papanastasopoulos, P, Tenant-Flowers, M, Webb, A, Burns, F, Marcus, R, Orkin, C, Montoto, S & Bower, M 2014, 'HIV status does not impair the outcome of patients diagnosed with diffuse large B-cell lymphoma treated with R-CHOP in the cART era', Aids, vol. 28, no. 5, pp. 689-697. https://doi.org/10.1097/QAD.0000000000000133

TY - JOUR

T1 - HIV status does not impair the outcome of patients diagnosed with diffuse large B-cell lymphoma treated with R-CHOP in the cART era

AU - Coutinho, Rita

AU - Pria, Alessia D.

AU - Gandhi, Shreyans

AU - Bailey, Katharine

AU - Fields, Paul

AU - Cwynarski, Kate

AU - Wilson, Andrew

AU - Papanastasopoulos, Panagiotis

AU - Tenant-Flowers, Melinda

AU - Webb, Andrew

AU - Burns, Fiona

AU - Marcus, Robert

AU - Orkin, Chloe

AU - Montoto, Silvia

AU - Bower, Mark

PY - 2014/3/13

Y1 - 2014/3/13

N2 - Objective:To compare the outcome of patients diagnosed with HIV infection and diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP in the cART era with that of a HIV-negative control group.Methods:From 2003 to 2011, 305 patients (97 HIV-positive) were diagnosed with DLBCL and treated with R-CHOP. Clinical features were compared using chi-square or Fisher's exact test. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Multivariate analysis was performed using the Cox regression proportional hazards model.Results:HIV-positive patients had more B symptoms and extranodal sites of disease at diagnosis, but the proportion of patients with high-intermediate/high-risk disease according to the international prognostic index (IPI) was similar between groups. Response rate was 73%, both for patients with and without HIV infection. After a median follow-up of 48 months, 30 patients relapsed after achieving a complete remission, including four HIV-positive patients. Ninety-six patients have died (19 HIV-positive), 73 of them due to DLBCL. Three patients (one HIV-positive) died due to treatment toxicity. Patients with HIV infection had a significantly longer disease-free survival (DFS) (5-year: 94 vs. 77%; P = 0.03) and overall survival (OS) (78 and 64% for HIV-positive and HIV-negative patients, respectively; P = 0.03). These results were confirmed on multivariate analysis when controlled for other potential prognostic confounders.Conclusion:HIV-positive patients diagnosed with DLBCL in the cART era have an excellent outcome when treated with standard immunochemotherapy. Therefore, the choice of chemotherapy in patients with lymphoma should not be influenced by HIV status.

AB - Objective:To compare the outcome of patients diagnosed with HIV infection and diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP in the cART era with that of a HIV-negative control group.Methods:From 2003 to 2011, 305 patients (97 HIV-positive) were diagnosed with DLBCL and treated with R-CHOP. Clinical features were compared using chi-square or Fisher's exact test. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Multivariate analysis was performed using the Cox regression proportional hazards model.Results:HIV-positive patients had more B symptoms and extranodal sites of disease at diagnosis, but the proportion of patients with high-intermediate/high-risk disease according to the international prognostic index (IPI) was similar between groups. Response rate was 73%, both for patients with and without HIV infection. After a median follow-up of 48 months, 30 patients relapsed after achieving a complete remission, including four HIV-positive patients. Ninety-six patients have died (19 HIV-positive), 73 of them due to DLBCL. Three patients (one HIV-positive) died due to treatment toxicity. Patients with HIV infection had a significantly longer disease-free survival (DFS) (5-year: 94 vs. 77%; P = 0.03) and overall survival (OS) (78 and 64% for HIV-positive and HIV-negative patients, respectively; P = 0.03). These results were confirmed on multivariate analysis when controlled for other potential prognostic confounders.Conclusion:HIV-positive patients diagnosed with DLBCL in the cART era have an excellent outcome when treated with standard immunochemotherapy. Therefore, the choice of chemotherapy in patients with lymphoma should not be influenced by HIV status.

KW - R-CHOP chemotherapy

KW - diffuse large B-cell lymphoma

KW - survival

KW - prognosis

KW - HIV

KW - outcome

KW - ACTIVE ANTIRETROVIRAL THERAPY

KW - NON-HODGKIN-LYMPHOMA

KW - AIDS-RELATED LYMPHOMA

KW - GENE-EXPRESSION

KW - PLUS RITUXIMAB

KW - PHASE-II

KW - CHEMOTHERAPY

KW - TRIAL

KW - SURVIVAL

KW - RISK

U2 - 10.1097/QAD.0000000000000133

DO - 10.1097/QAD.0000000000000133

M3 - Article

SN - 0269-9370

VL - 28

SP - 689

EP - 697

JO - Aids

JF - Aids

IS - 5

ER -

HIV status does not impair the outcome of patients diagnosed with diffuse large B-cell lymphoma treated with R-CHOP in the cART era

Abstract

Keywords

UN SDGs

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