Characteristics and Outcome of AIDS-Related Hodgkin Lymphoma Before and After the Introduction of Highly Active Antiretroviral Therapy.

Clinical Science

JAIDS Journal of Acquired Immune Deficiency Syndromes. 47(4):422-428, April 1, 2008.
Berenguer, Juan MD, PhD *; Miralles, Pilar MD *; Ribera, Jose Maria MD, PhD +; Rubio, Rafael MD, PhD ++; Valencia, Eulalia MD, PhD [S]; Mahillo, Beatriz MD [//]; Pintado, Vicente MD, PhD [P]; Palacios, Rosario MD, PhD #; Montes, Maria Luisa MD, PhD **; Tellez, Maria Jesus MD, PhD ++; La Cruz, Jose MD ++++; Torre-Cisneros, Julian MD, PhD [S][S]; Rodriguez-Arrondo, Francisco MD [//][//]; Sepulveda, Maria Antonia MD [P][P]; Gutierrez, Felix MD, PhD ##; Peralta, Galo MD, PhD ***; Boix, Vicente MD, PhD +++; on Behalf of the GESIDA Register of Systemic AIDS-Related Lymphomas

Abstract:
Objectives: We analyzed survival, therapeutic response, and prognostic factors in patients with HIV-related Hodgkin lymphoma (HL) treated or not with highly active antiretroviral therapy (HAART).

Methods: This study included 104 patients with HL, treated (n = 83) or not (n = 21) with HAART. Outcomes and prognostic factors of complete remission (CR), overall survival (OS), and disease-free survival (DFS) were assessed by an intention-to-treat analysis of all patients who received at least 1 chemotherapy course.

Results: No differences were found between groups at baseline in the specific characteristics of HIV and HL. The proportion of patients receiving appropriate-for-stage therapy for HL was similar for both groups. The CR rates in the HAART (-) and HAART (+) groups were 14 (70%) of 20 versus 71 (91%) of 78 (P = 0.023). The median OS in the HAART (-) group was 39 months (95% confidence interval [CI]: 0 to 89) and was not reached in the HAART (+) group (P = 0.0089). The median DFS in the HAART (-) group was 85 months (95% CI: 73 to 97) and was not reached in the HAART (+) group (P = 0.129). Factors independently associated with CR by logistic regression analysis were appropriate-for-stage therapy of HL, HAART, and baseline CD4 count >=100 cells/[mu]L. CR was the only factor independently associated with OS by Cox regression analysis.

Conclusions: The achievement of CR was independently associated with appropriate-for-stage therapy for HL, with HAART, and with a baseline CD4 count >=100 cells/[mu]L. The only variable independently associated with OS was the achievement of CR.

(C) 2008 Lippincott Williams & Wilkins, Inc.