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HIV Status Does Not Influence Outcome in Patients With Classical Hodgkin Lymphoma Treated With Chemotherapy Using Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine in the Highly Active Antiretroviral Therapy Era.
MedLine Citation:
PMID:  23045581     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSEThe prognosis of HIV-infected patients with non-Hodgkin lymphoma in the highly active antiretroviral therapy (HAART) era approaches that of the general population when they are treated with the same protocols. We analyzed the outcome of patients with Hodgkin lymphoma (HL) treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in the HAART era according to HIV serostatus to establish whether this also holds true for HL. PATIENTS AND METHODSFrom 1997 to 2010, 224 patients newly diagnosed with HL, of whom 93 were HIV positive, were consecutively treated with ABVD chemotherapy. HIV-positive patients had more high-risk disease according to the International Prognostic Score (IPS) than HIV-negative patients (IPS ≥ 3: 68% v 26%, respectively; P < .001). Forty-seven HIV-positive patients had a CD4 count less than 200/μL, and 92 patients received HAART during chemotherapy.ResultsThe complete response rate was 74% for HIV-positive patients and 79% for HIV-negative patients (P = not significant). After a median follow-up of 60 months (range, 8 to 174 months), 23 patients (16 HIV-negative and seven HIV-positive patients) have experienced relapse at a median time of 6 months (range, 1 to 106 months). Five-year event-free survival (EFS) was 59% (95% CI, 47% to 70%) for HIV-positive patients and 66% (95% CI, 57% to 74%) for HIV-negative patients (P = not significant). Five-year overall survival (OS) was 81% (95% CI, 69% to 89%) and 88% (95% CI, 80% to 93%) for HIV-positive and HIV-negative patients, respectively (P = not significant). HIV status did not predict OS or EFS on multivariate analysis including IPS and HIV status. CONCLUSIONThis mature study demonstrates that HIV-positive patients with HL have more extensive disease with more adverse prognostic factors than HIV-negative patients, but when treated with ABVD, HIV infection does not adversely affect OS or EFS.
Authors:
Silvia Montoto; Kate Shaw; Jessica Okosun; Shreyans Gandhi; Paul Fields; Andrew Wilson; Milensu Shanyinde; Kate Cwynarski; Robert Marcus; Johannes de Vos; Anna Marie Young; Melinda Tenant-Flowers; Chloe Orkin; Margaret Johnson; Daniella Chilton; John G Gribben; Mark Bower
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-8
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  -     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Silvia Montoto, Andrew Wilson, Johannes de Vos, and John G. Gribben, Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London; Kate Shaw, Anna Marie Young, and Mark Bower, Chelsea and Westminster Hospital; Jessica Okosun, Kate Cwynarski, and Margaret Johnson, Royal Free Hospital; Shreyans Gandhi, Robert Marcus, and Melinda Tenant-Flowers, King's College Hospital; Paul Fields, Guy's and St Thomas Hospital; Chloe Orkin, Barts and The London National Health Service (NHS) Trust; Daniella Chilton, Guy's and St Thomas' NHS Foundation Trust, London; and Milensu Shanyinde, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom.
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