Improved survival and chemotherapy response among patients with AIDS-related non-Hodgkin's lymphoma receiving highly active antiretroviral therapy.
Highly active antiretroviral therapy (HAART) became available in the US in 1996. Using the population-based cancer registry, we identified 233 patients with AIDS-related systemic NHL diagnosed in San Diego or Orange County in 1994-1999, of whom 137 were diagnosed 1996-1999. We performed Kaplan-Meier analyses to compare survival between patients who received HAART at NHL diagnosis or thereafter versus untreated patients and Cox proportional hazard models for adjusted survival. We used logistic regression to determine if concomitant HAART changed the probability of complete response to chemotherapy and the Mann-Whitney U-test to compare the median number of chemotherapy cycles between patients who received HAART during chemotherapy versus those who did not. Among patients diagnosed with NHL in 1996-1999, 40 (29%) were taking HAART at NHL diagnosis. The median survival was three months among patients who did not receive HAART versus 16 months among HAART-treated patients. HAART, chemotherapy, high performance status, and NHL stage < IV were associated with improved survival. Concomitant HAART, completion of > or = 6 chemotherapy cycles, and NHL stage < IV were associated with complete response to chemotherapy. The median number of chemotherapy cycles was five among patients who received HAART concomitant with chemotherapy versus three among untreated patients. We conclude that HAART should be initiated or continued after NHL diagnosis, including during the period of chemotherapy administration.
Diamond
Catherine
C
University of California, Irvine Department of Medicine, CA, USA. diamondc@uci.edu
Taylor
Thomas H
TH
Im
Theresa
T
Miradi
Mohammed
M
Anton-Culver
Hoda
H
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D005260:Female; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate