Abstract | OBJECTIVE: To analyze the factors associated with survival in the largest cohort of individuals with HIV and lymphoma so far described in Brazil. DESIGN: A retrospective, observational, multicenter study involving five institutions in São Paulo, Brazil. METHODS: The medical records of consecutive patients with HIV diagnosed with lymphoma between January 2000 and December 2019 were screened. Inclusion criteria consisted of age over 17 years and a biopsy-confirmed diagnosis of lymphoma. The data collected included age, sex, staging (Ann Arbor system), duration of HIV infection, CD4 + lymphocyte count, HIV viral load, lactate dehydrogenase, erythrocyte sedimentation rate and serum beta-2-microglobulin levels, treatment and outcome. RESULTS: Overall, 276 patients were included. Median age was 42 years. Most patients were male (74.3%) and with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (28.6% and 46.4%, respectively). Most had non-Hodgkin lymphomas (89.2%, n = 246), particularly diffuse large B-cell lymphoma (40.9%) and Burkitt lymphoma (26.4%). Hodgkin lymphoma accounted for 9.4%. Advanced stages III/IV were predominant (86.8%). HIV viral load at the moment of lymphoma diagnosis was detectable in 52.9% of patients. A CD4 + cell count of <200 cells/μl was recorded for 53% of the patients. Most patients (62.4%) were on combination antiretroviral therapy. The factors that significantly affected survival were: the ECOG performance status, lymphoma subtype, staging, beta-2-microglobulin level, central nervous system (CNS) infiltration, site of CNS infiltration, relapsed/refractory lymphoma and International Prognostic Index score. CONCLUSIONS: HIV status, CD4 + -lymphocyte count and relapsed/refractory disease affected survival. Rituximab did not appear to improve outcome in HIV-related lymphomas.
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Authors | Juliano Cordova Vargas, Mariana de Oliveira Marques, Juliana Pereira, Walter M Tobias Braga, Nelson Hamerschlak, Jacques Tabacof, Paulo Roberto Abrão Ferreira, Gisele W Braga Colleoni, Otavio C G Baiocchi |
Journal | AIDS (London, England)
(AIDS)
Vol. 37
Issue 8
Pg. 1217-1226
(07 01 2023)
ISSN: 1473-5571 [Electronic] England |
PMID | 36939075
(Publication Type: Multicenter Study, Journal Article)
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Copyright | Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. |
Topics |
- Humans
- Male
- Adult
- Adolescent
- Female
- HIV Infections
(drug therapy, complications)
- Retrospective Studies
- Brazil
(epidemiology)
- Lymphoma, Non-Hodgkin
- Lymphoma, Large B-Cell, Diffuse
(drug therapy)
- Lymphoma, AIDS-Related
(drug therapy, complications)
- Prognosis
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects)
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