Impact of highly active antiretroviral therapy in the treatment of HIV-infected patients with systemic non-Hodgkin's lymphoma.
Twenty cases of systemic non-Hodgkin's lymphoma (NHL) in HIV-infected patients were reviewed over a 10-year-period, divided into Group A, including 13 NHL cases treated before the highly active antiretroviral therapy (HAART) era, and Group B, including 7 patients who received HAART. A Kaplan-Meier survival curve was performed and log-rank was applied to assess statistical differences between the groups. In group A, the median CD4 count was 36 cells/mm3. No complete remission was found. In group B, the median CD4 count was 137 cells/mm3. Four patients (57.0%) are still alive and in complete remission. Group A had a median survival of 5 months and group B 31 months (p = 0.0032). Our results are in agreement with recent reports in that a higher CD4 count and better immune status achieved with HAART is predictive of a better outcome. We found that HAART in combination with chemotherapy improves overall survival of NHL patients without increasing adverse effects.
Baiocchi
Otavio C G
OC
Hematology and Transfusion Service, Universidade Federal de São Paulo, Brazil.
Colleoni
Gisele W B
GW
Navajas
Eduardo V
EV
Duarte
Luiz Claudio C
LC
Alves
Antonio C
AC
Andrade
Ana Lucia S S
AL
Kerbauy
Jose
J
Oliveira
Jose Salvador R
JS
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D012189:Retrospective Studies; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use*
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone