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Non-Hodgkin Lymphoma
Incidence and risk factors for relapses in HIV-associated non-Hodgkin lymphoma as observed in the German HIV-related lymphoma cohort study
Philipp Schommers,1,2,* Daniel Gillor,1,* Marcus Hentrich,3 Christoph Wyen,1,4 Timo Wolf,5 Mark Oette,6 Alexander Zoufaly,7 Jan-Christian Wasmuth,8 Johannes R. Bogner,9 Markus Müller,10 Stefan Esser,11 Alisa Schleicher,12 Björn Jensen,13 Albrecht Stoehr,14 Georg Behrens,15,16 Alexander Schultze,17 Jan Siehl,18 Jan Thoden,19 Ninon Taylor20 and Christian Hoffmann12,21
1Department I of Internal Medicine, University Hospital Cologne, Germany; 2German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Germany; 3Department of Medicine III, Red Cross Hospital Munich, Germany; 4Praxis am Ebertplatz, Cologne, Germany; 5Department of Medicine II, University of Frankfurt, Germany; 6Department of General Medicine, Gastroenterology and Infectious Diseases, Augustinerinnen Hospital, Cologne, Germany; 7Department of Medicine IV, Kaiser Franz Josef Hospital, Vienna, Austria; 8Department of Internal Medicine I, University of Bonn, Germany; 9Department of Medicine IV, University of Munich, Munich, Germany; 10Department of Infectious Diseases, Vivantes Auguste-Viktoria- Hospital, Berlin, Germany; 11Department of Dermatology, University Hospital Essen, Germany; 12University of Schleswig Holstein, Campus Kiel, Kiel, Germany; 13Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Germany; 14Ifi-Institute for Interdisciplinary Medicine, Hamburg, Germany; 15Department of Clinical Immunology and Rheumatology, Hannover Medical School, Germany; 16German Center for Infection Research (DZIF), Hannover, Germany; 17Department of Emergency Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 18Ärzteforum Seestraße, Berlin, Germany; 19Medical Group Practice for Internal Medicine and Rheumatology, Freiburg, Germany; 20Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Laboratory of Immunological and Molecular Cancer Research, Paracelsus Medical University Salzburg, Austria and 21IPM Study Center, Hamburg, Germany
*PS and DG contributed equally to this work.
ABSTRACT
Outcome of HIV-infected patients with AIDS-related lymphomas has improved during recent years. However, data on incidence, risk factors, and outcome of relapses in AIDS-related lym- phomas after achieving complete remission are still limited. This prospective observational multicenter study includes HIV-infected patients with biopsy- or cytology-proven malignant lymphomas since 2005. Data on HIV infection and lymphoma characteristics, treatment and outcome were recorded. For this analysis, AIDS-related lymphomas patients in complete remission were analyzed in terms of their relapse- free survival and potential risk factors for relapses. In total, 254 of 399 (63.7%) patients with AIDS-related lymphomas reached a complete remission with their first-line chemotherapy. After a median follow up of 4.6 years, 5-year overall survival of the 254 patients was 87.8% (Standard Error 3.1%). Twenty-nine patients relapsed (11.4%). Several factors were independently associated with a higher relapse rate, includ- ing an unclassifiable histology, a stage III or IV according to the Ann Arbor Staging System, no concomitant combined antiretroviral therapy during chemotherapy and R-CHOP-based compared to more intensive chemotherapy regimens in Burkitt lymphomas. In conclusion, complete remission and relapse rates observed in our study are similar to those reported in HIV-negative non-Hodgkin lymphomas. These data provide further evidence for the use of concomitant combined antiretroviral ther- apy during chemotherapy and a benefit from more intensive chemother- apy regimens in Burkitt lymphomas. Modifications to the chemotherapy regimen appear to have only a limited impact on relapse rate.
Ferrata Storti Foundation
Haematologica 2018 Volume 103(5):857-864
Correspondence:
philipp.schommers@uk-koeln.de
Received: September 17, 2017. Accepted: February 2, 2018. Pre-published: February 8, 2018.
doi:10.3324/haematol.2017.180893
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/103/5/857
©2018 Ferrata Storti Foundation
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