AIDS-related lymphoma (ARL): Efficacy of highly active anti retroviral therapy (HAART) on survival and prognostic factors in a general hospital in Peru

e19545 Background: Since the introduction of HAART in 1996, the profile of ARL has shifted considerably. The impact of HAART on the survival of ARL in developing countries in the post-HAART era has not been clearly defined. The aims of this study were to evaluate efficacy of HAART on survival and prognostic factors in our population. Methods: The clinical records of 2,502 HIV-infected patients seen in our institution from March 1997 to March 2008 were reviewed. The survival was calculated using the Kaplan-Meier method and the prognostic factors were evaluated by chi square. Results: Forty-eight patients with HIV-associated lymphoma were identified. From the 48 ARL identified 44 were non Hodgkin lymphoma (NHL) and 4 were Hodgkin lymphoma. Two patients with CNS primary were excluded for analysis. From 42 systemic NHL: 38 (90,5%) were of B-cell and 4 (9,5%) were of T-cell. The 5-year overall survival (OS) was 27%. Three groups of patients were included: 13 patients (31%) received HAART previous the diagnosis of ARL, 21 patients (50%) initiated HAART after ARL diagnosis and 8 patients (19%) did not receive HAART. HAART treatment before the diagnosis of NHL increases the survival (54% versus 9,5% versus 25% respectively, p=0.048). Twenty of 42 patients (47,6%) received chemotherapy. This group had a better survival rate than those who did not receive chemotherapy (50% versus 4,5%, p< 0.0001) The overall response to chemotherapy was 80% with CR (n=11, 55%), PR(n=5, 25%) and PD in four (20%). In a multivariate analysis, IPI score > 2, presence of B symptoms and no HAART previous ARL diagnosis were statistically associated to worse survival with p-values of 0.0001, 0.018 and 0.048 respectively. Conclusions: In our study the use of HAART is effective when started before ARL diagnosis. IPI score > 2, B symptoms and no HAART previous the diagnosis were unfavorable prognostic factors. These latest findings are in concordance with prior reports. This is the first Latinamerican report on the impact of HAART on the OS in ARL patients. No significant financial relationships to disclose.

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Ritonavir Based Highly Active Retroviral Therapy (HAART) Correlates with Early Neurotoxicity When Combined with ABVD Treated HIV Associated Hodgkin Lymphoma but Not Non-Hodgkin Lymphoma. A Retrospective Study.

Blood ◽

10.1182/blood.v116.21.2807.2807 ◽

2010 ◽

Vol 116 (21) ◽

pp. 2807-2807 ◽

Cited By ~ 4

Author(s):

Paul G. Rubinstein ◽

Tareq Braik ◽

Shivi Jain ◽

Jennifer Orsi ◽

Shweta Gupta ◽

...

Keyword(s):

Adverse Events ◽

Hodgkin Lymphoma ◽

Chemotherapy Regimen ◽

B Cell Lymphoma ◽

Study Patient ◽

Hiv Therapy ◽

Non Hodgkin Lymphoma ◽

Highly Active ◽

Common Diagnosis ◽

The Impact

Abstract Abstract 2807 Background: Hodgkin (HL) and non-Hodgkin lymphoma (NHL) are the most common non-HIV-defining and HIV-defining malignancies, respectively1. Patients (pts) treated for lymphoma concomitantly with highly active retroviral therapy (HAART) have much better response rates and overall survival2. However, few studies have assessed the impact of HAART on the adverse events of chemotherapy. The Stanford V regimen for HL has a 48 % increase in neurotoxicity and neutropenia when taken concomitantly with HAART compared to non-HIV patients3. Case reports exist associating gastrointestinal and neurotoxicity with vinblastine (less so vincristine) and ritonavir-based HIV therapy. Unfortunately, the frequency of this association has yet to be shown. We retrospectively analyzed pts at our institution with lymphomas and HIV and the relationship between HAART and chemotherapy adverse events (AE) in an attempt to minimize future chemotherapy-related complications. Methods: We retrospectively identified HIV infected patients treated for lymphoma (2002-2008) at Stroger Hospital of Cook County by computer database search using ICD9 and pharmacy codes and then confirmed by medical record review. The adverse events during chemotherapy were assessed by chart review and graded per the NCI Common Terminology Criteria for Adverse Events. Those pts where HAART or chemotherapy regimen could not be confirmed were excluded from the study. Patient, disease, and the HIV characteristics were assessed. Statistics: A non-parametric Fisher's exact test was used to examine the difference in proportion of patients that developed an adverse event in the pts with a particular HAART medication and the ones without. Results: Twenty-five HIV infected pts with HL and 46 pts with NHL were identified. Identification of HAART administered during chemotherapy was found in 23/25 (92%) pts with HL and 22/46 (48%) pts with NHL. Patients diagnosed with HL were 87% male with a median age of 43. Mixed cellularity (26%) and nodular sclerosis (26%) pathologies were the most common with 60% (14/23 pts) presenting as stage III/IV disease. The median CD4 count at diagnosis was 174 cell/ml with a range of 26–341. The most common HAART regimen was efavirenz/emtricitabine/tenofovir (17%), though ritonavir-based regimens accounted for 48% of all HIV treatments. Twenty-six percent (6/23 pts) had neurotoxicity (13% G3, 4% G2, 8% G1) and among those with any neurotoxicity,100% were taking ritonavir. Each of the 3 pts with G3 neurotoxicity, and the patient with G3 constipation experienced their AE after just 1 to 2 doses of vinblastine (before cycle #2). Each pt with G3 neurotoxicity, vinblastine was held with only slight improvement in symptoms. A statistically significant difference in the proportion of patients that developed neurotoxic effects after initiation of vinblastine was observed in the ritonavir vs. non-ritonavir based HAART therapy groups (55% vs. 0%, p<0.01). The most common non-hematological side effects were nausea and vomiting (29%) and neuropathy (28%; 13% G3 and 25%G1 and 2). Twenty-nine percent of the pts had G4 neutropenia. Two deaths occurred during induction therapy secondary to CMV pneumonia and cryptococcal infection. In contrast, no correlation was found between any HAART and AE in any vincristine-based chemotherapy regimen used to treat NHL. The most common diagnosis was diffuse large B cell lymphoma (63%). All 22 pts received CHOPR (63%), HYPERCVAD (27%), or CHOP (9%). Thirty-two percent (7/22 pts) were placed on a ritonavir based HAART, but no G3/4 neurotoxicity were observed. No G4 complications were seen aside from neutropenia (18%). Conclusions: Ritonavir-based HIV therapy in conjunction with ABVD (vinblastine based) in the treatment of HL was both temporally and statistically associated with serious, sometimes irreversible neurologic toxicity after just one dose of vinblastine. This same relationship was not seen in vincristine-based therapies for NHL. These data suggest that the CYP3A4 enzyme inhibition caused by ritonavir leads to severe vinblastine-associated adverse events and clinicians should consider non-ritonavir based HIV therapy during ABVD treatment for HL. Disclosures: No relevant conflicts of interest to declare.

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The impact of Kaposi sarcoma and non-Hodgkin lymphoma on mortality of people with AIDS in the highly active antiretroviral therapies era

Cancer Epidemiology ◽

10.1016/j.canep.2010.03.011 ◽

2010 ◽

Vol 34 (3) ◽

pp. 257-261 ◽

Cited By ~ 11

Author(s):

Diego Serraino ◽

Angela De Paoli ◽

Antonella Zucchetto ◽

Simona Pennazza ◽

Silvia Bruzzone ◽

...

Keyword(s):

Hodgkin Lymphoma ◽

Kaposi Sarcoma ◽

Non Hodgkin Lymphoma ◽

Highly Active ◽

Antiretroviral Therapies ◽

The Impact

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Effect of prior cancer on survival outcomes for patients with advanced prostate cancer

BMC Urology ◽

10.1186/s12894-021-00792-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yechen Wu ◽

Xi Chen ◽

Duocheng Qian ◽

Wei Wang ◽

Yiping Zhang ◽

...

Keyword(s):

Prostate Cancer ◽

Clinical Outcomes ◽

Cancer Diagnosis ◽

Advanced Prostate Cancer ◽

Lymphocytic Leukemia ◽

Cancer History ◽

Non Hodgkin Lymphoma ◽

Kaplan Meier ◽

History Of ◽

The Impact

Abstract Background A history of prior cancer commonly results in exclusion from cancer clinical trials. However, whether a prior cancer history has an adversely impact on clinical outcomes for patients with advanced prostate cancer (APC) remains largely unknown. We therefore aimed to investigate the impact of prior cancer history on these patients. Methods We identified patients with advanced prostate cancer diagnosed from 2004 to 2010 in the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan–Meier method and the Cox proportional hazard model were utilized for survival analysis. Results A total of 19,772 eligible APC patients were included, of whom 887 (4.5 %) had a history of prior cancer. Urinary bladder (19 %), colon and cecum (16 %), melanoma of the skin (9 %) malignancies, and non-hodgkin lymphoma (9 %) were the most common types of prior cancer. Patients with a history of prior cancer had slightly inferior overall survival (OS) (AHR = 1.13; 95 % CI [1.02–1.26]; P = 0.017) as compared with that of patients without a prior cancer diagnosis. Subgroup analysis further indicated that a history of prior cancer didn’t adversely impact patients’ clinical outcomes, except in patients with a prior cancer diagnosed within 2 years, at advanced stage, or originating from specific sites, including bladder, colon and cecum, or lung and bronchus, or prior chronic lymphocytic leukemia. Conclusions A large proportion of APC patients with a prior cancer history had non-inferior survival to that of patients without a prior cancer diagnosis. These patients may be candidates for relevant cancer trials.

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Plasma phospholipid changes are associated with response to chemotherapy in non-Hodgkin lymphoma patients

Leukemia Research ◽

10.1016/j.leukres.2017.01.004 ◽

2017 ◽

Vol 54 ◽

pp. 39-46 ◽

Cited By ~ 2

Author(s):

Zorica Cvetković ◽

Maja Milošević ◽

Bora Cvetković ◽

Romana Masnikosa ◽

Aleksandra Arsić ◽

...

Keyword(s):

Hodgkin Lymphoma ◽

Plasma Phospholipid ◽

Non Hodgkin Lymphoma ◽

Response To Chemotherapy

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Non-Hodgkin lymphoma incidence in the Swiss HIV Cohort Study before and after highly active antiretroviral therapy

AIDS ◽

10.1097/qad.0b013e3282f2705d ◽

2008 ◽

Vol 22 (2) ◽

pp. 301-306 ◽

Cited By ~ 92

Author(s):

Jerry Polesel ◽

Gary M Clifford ◽

Martin Rickenbach ◽

Luigino Dal Maso ◽

Manuel Battegay ◽

...

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Hodgkin Lymphoma ◽

Highly Active Antiretroviral Therapy ◽

Non Hodgkin Lymphoma ◽

Highly Active ◽

Before And After

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Prognostic factors after non-Hodgkin lymphoma in patients infected with the human immunodeficiency virus

Cancer ◽

10.1002/(sici)1097-0142(20000401)88:7<1696::aid-cncr25>3.0.co;2-l ◽

2000 ◽

Vol 88 (7) ◽

pp. 1696-1702 ◽

Cited By ~ 28

Author(s):

Frantz Thiessard ◽

Philippe Morlat ◽

Catherine Marimoutou ◽

Eric Labouyrie ◽

Jean-Marie Ragnaud ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Prognostic Factors ◽

Hodgkin Lymphoma ◽

Non Hodgkin Lymphoma ◽

Immunodeficiency Virus

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Prognostic factors in non-Hodgkin lymphomas

Sao Paulo Medical Journal ◽

10.1590/s1516-31802000000100003 ◽

2000 ◽

Vol 118 (1) ◽

pp. 7-12 ◽

Cited By ~ 1

Author(s):

Karin Zattar Cecyn ◽

José Salvador Rodrigues de Oliveira ◽

Antônio Correia Alves ◽

Maria Regina Regis Silva ◽

José Kerbauy

Keyword(s):

Prognostic Factors ◽

Hodgkin Lymphoma ◽

Low Grade ◽

High Grade ◽

Cns Involvement ◽

Intermediate Grade ◽

Non Hodgkin Lymphoma ◽

Tumor Dissemination ◽

Mediastinal Disease ◽

Extranodal Disease

CONTEXT: In Hodgkin's disease, each clinical or pathologic stage can be related to the extent of the area involved and predicts the next anatomical region at risk for tumor dissemination. OBJECTIVE: To determine the best prognostic factors that could predict survival in non-Hodgkin lymphoma cases. DESIGN: A retrospective study. LOCATION: Department of Hematology and Transfusion Medicine, Universidade Federal de São Paulo - Escola Paulista de Medicina. PARTICIPANTS: 142 patients with non-Hodgkin lymphoma diagnosed between February 1988 and March 1993. MAIN MEASUREMENTS: Histological subset, Sex, Age, Race, B symptoms, Performance status, Stage, Extranodal disease, Bulk disease, Mediastinal disease, CNS involvement, BM infiltration, Level of DHL, Immunophenotype. RESULTS: In the first study (113 patients), the following variables had a worse influence on survival: yellow race (P<0.1); ECOG II, III e IV (P<0.1) and extranodal disease (P<0.1) for high grade lymphomas; constitutional symptoms (P<0.1), ECOG II, III e IV (P<0.1) and involvement of CNS (P<0.1) for intermediate grade and the subtype lymphoplasmocytoid (P=0.0186) for low grade lymphomas. In the second survey (93 patients), when treatment was included, the variables related to NHL survival were: CNS involvement (P<0.1) for high grade lymphomas, constitutional symptoms (P<0.1), ECOG II, III, IV (P=0.0185) and also CNS involvement (P<0.1) for the intermediate group. There were no variables related to the survival for low-grade lymphomas. CONCLUSIONS: The intermediate grade lymphomas were more compatible with data found in the literature, probably because of the larger number of patients. In this specific case, the treatment did not have an influence on the survival.

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Cancer Risk After Bariatric Surgery in a Cohort Study from the Five Nordic Countries

Obesity Surgery ◽

10.1007/s11695-020-04751-6 ◽

2020 ◽

Vol 30 (10) ◽

pp. 3761-3767

Author(s):

Wenjing Tao ◽

Giola Santoni ◽

My von Euler-Chelpin ◽

Rickard Ljung ◽

Elsebeth Lynge ◽

...

Keyword(s):

Bariatric Surgery ◽

Endometrial Cancer ◽

Cohort Study ◽

Cancer Risk ◽

Hodgkin Lymphoma ◽

Cox Regression ◽

Nordic Countries ◽

Chronic Obstructive ◽

Non Hodgkin Lymphoma ◽

The Impact

Abstract Purpose Obesity increases the risk of several cancers, but the influence of bariatric surgery on the risk of individual obesity-related cancers is unclear. This study aimed to assess the impact of bariatric surgery on cancer risk in a multi-national setting. Materials and Methods This cohort study included all adults with an obesity diagnosis identified from national patient registries in all Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) from 1980 to 2012. Cancer risk in bariatric surgery patients was compared with non-operated patients with obesity. Multivariable Cox regression provided adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Age, sex, calendar year, country, length of follow-up, diabetes, chronic obstructive pulmonary disease and alcohol-related diseases were evaluated as confounders. Results Among 482,572 participants with obesity, 49,096 underwent bariatric surgery. Bariatric surgery was followed by a decreased overall cancer risk in women (HR 0.86, 95% CI 0.80–0.92), but not in men (HR 0.98, 95% CI 0.95–1.01). The risk reduction was observed only within the first five post-operative years. Among specific tumours, HRs decreased for breast cancer (HR 0.81, 95% CI 0.69–0.95), endometrial cancer (HR 0.69, 95% CI 0.56–0.84) and non-Hodgkin lymphoma (HR 0.64, 95% CI 0.42–0.97) in female bariatric surgery patients, while the risk of kidney cancer increased in both sexes (HR 1.44, 95% CI 1.13–1.84). Conclusion Bariatric surgery may decrease overall cancer risk in women within the first five years after surgery. This decrease may be explained by a decreased risk of breast and endometrial cancer and non-Hodgkin lymphoma in women.

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