Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: A pooled analysis of 1546 patients Journal Article

Authors: Barta, S. K.; Xue, X.; Wang, D.; Tamari, R.; Lee, J. Y.; Mounier, N.; Kaplan, L. D.; Ribera, J. M.; Spina, M.; Tirelli, U.; Weiss, R.; Galicier, L.; Boue, F.; Wilson, W. H.; Wyen, C.; Oriol, A.; Navarro, J. T.; Dunleavy, K.; Little, R. F.; Ratner, L.; Garcia, O.; Morgades, M.; Remick, S. C.; Noy, A.; Sparano, J. A.
Article Title: Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: A pooled analysis of 1546 patients
Abstract: Limited comparative data exist for the treatment of HIV-associated non-Hodgkin lymphoma. We analyzed pooled individual patient data for 1546 patients from 19 prospective clinical trials to assess treatment-specific factors (type of chemotherapy, rituximab, and concurrent combination antiretroviral [cART] use) and their influence on the outcomes complete response (CR), progression free survival (PFS), and overall survival (OS). In our analysis, rituximab was associated with a higher CR rate (odds ratio [OR] 2.89; P <.001), improved PFS (hazard ratio [HR] 0.50; P <.001), and OS (HR 0.51; P <.0001). Compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), initial therapy with more dose-intense regimens resulted in better CR rates (ACVBP [doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisolone]: OR 1.70; P <.04), PFS (ACVBP: HR 0.72; P 5.049; "intensive regimens": HR 0.35; P <.001) and OS ("intensive regimens": HR 0.54; P <.001). Infusional etoposide, prednisone, infusional vincristine, infusional doxorubicin, and cyclophosphamide (EPOCH) was associated with significantly better OS in diffuse large B-cell lymphoma (HR 0.33; P 5.03). Concurrent use of cART was associated with improved CR rates (OR 1.89; P 5.005) and trended toward improved OS (HR 0.78; P 5.07). These findings provide supporting evidence for current patterns of care where definitive evidence is unavailable. © 2013 by The American Society of Hematology.
Keywords: adult; cancer survival; aged; major clinical study; overall survival; prednisone; doxorubicin; cancer combination chemotherapy; cancer patient; primary central nervous system lymphoma; cytarabine; methotrexate; rituximab; human immunodeficiency virus infection; follow up; progression free survival; etoposide; cyclophosphamide; dexamethasone; vincristine; stem cell transplantation; ifosfamide; procarbazine; prednisolone; nonhodgkin lymphoma; bleomycin; medline; vindesine; large cell lymphoma; virus load; burkitt lymphoma; teniposide; antiviral therapy; international prognostic index; anti human immunodeficiency virus agent; antiretroviral therapy; telecommunication; human; male; female; priority journal; article; hiv associated nonhodgkin lymphoma
Journal Title: Blood
Volume: 122
Issue: 19
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2013-11-07
Start Page: 3251
End Page: 3262
Language: English
DOI: 10.1182/blood-2013-04-498964
PROVIDER: scopus
PMCID: PMC3821722
PUBMED: 24014242
Notes: Cited By (since 1996):1 -- Export Date: 2 January 2014 -- CODEN: BLOOA -- Source: Scopus
Citation Impact
MSK Authors
  1. Ariela Noy
    229 Noy
  2. Roni Tamari
    99 Tamari