AEGiS-13IAC: Effect of HAART on response to therapy and survival in patients with AIDS-related non-Hodgkin's lymphoma (NHL).

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Effect of HAART on response to therapy and survival in patients with AIDS-related non-Hodgkin's lymphoma (NHL).

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB303)

Romeu J, Navarro T, Tural C, Sirera G, Ribera JM, Clotet B
J. Romeu, Germans Trias i Pujolo University Hospital, Ctra. Canyet s/n, 08916 BADALONA, Spain, Tel.: +34 93 497 88 87, Fax: +34 93 465 76 02, E-mail: jromeu@ns.hugtip.scs.es

BACKGROUND: There are few studies focusing on the effect of HAART on the response to treatment and overall survival (OS) in AIDS-related NHL. We analyzed the influence of HAART on clinical and biological features, response to treatment and OS in a series of 57 patients (pts) with AIDS-related NHL treated with CHOP between 1988 and 1999.

METHODS: Variables analyzed were: age, gender, risk behaviour, B symptoms, hematologic and biochemical parameters, CD4+ lymphocyte count, extranodal involvement, histological subtype (REAL), international prognostic index (IPI) score, response to treatment, and OS. Two groups were considered: 1) 41 pts diagnosed between 1988 and 1996 who were not treated with HAART; 2) 16 pts diagnosed since 1996 who received HAART.

RESULTS: Except for gender (4 women in group 1 vs 6 in group 2 (p = 0.01)) and serum LDH (mean (SD) LDH was 1,063 (1,528) U/L in group 1 and 223 (119) U/L in group 2 (p = 0.002)), both groups were comparable for age, risk behaviour, hematologic parameters, and CD4+ lymphocyte count. Response rate was higher in pts treated with CHOP and HAART (10 out of 14, 71%) than in those treated only with CHOP (14 out of 41, 34%) (p = 0.01). HAART was the only variable with positive influence on remission attainment in the multivariate analysis (p = 0.02). The median OS for group 1 pts was 7 months, whereas it has not been reached in pts of group 2 (p = 0.002). In the univariate analysis the factors with negative influence on OS were: B symptoms, increased serum LDH and IPI score >1, whereas HAART had a positive influence. The variables with prognostic value on OS in the multivariate analysis were B symptoms (p = 0.02) and HAART as a positive factor (p = 0.007).

CONCLUSIONS: Pts with AIDS-related NHL treated with CHOP and HAART had a higher respose rate than those treated only with CHOP. In our study HAART was the main prognostic factor for OS and achieving remission in HIV-pts with NHL.

Keywords: AEGIS, Lymphoma, AIDS-Related, Antiretroviral Therapy, Highly Active, Vincristine, Cyclophosphamide, Doxorubicin, Prednisone, CD4 Lymphocyte Count, Acquired Immunodeficiency Syndrome, Antineoplastic Combined Chemotherapy Protocols, HIV Infections, Survival Rate, Survival Analysis, Disease-Free Survival, Remission Induction, Drug Therapy, Combination, Survival, CHOP protocol, Human, Female, therapy, mortality, drug therapy
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