Characteristics and outcome of AIDS-related Hodgkin lymphoma before and after the introduction of highly active antiretroviral therapy.
OBJECTIVE
We analyzed survival, therapeutic response, and prognostic factors in patients with HIV-related Hodgkin lymphoma (HL) treated or not with highly active antiretroviral therapy (HAART).


METHODS
This study included 104 patients with HL, treated (n = 83) or not (n = 21) with HAART. Outcomes and prognostic factors of complete remission (CR), overall survival (OS), and disease-free survival (DFS) were assessed by an intention-to-treat analysis of all patients who received at least 1 chemotherapy course.


RESULTS
No differences were found between groups at baseline in the specific characteristics of HIV and HL. The proportion of patients receiving appropriate-for-stage therapy for HL was similar for both groups. The CR rates in the HAART (-) and HAART (+) groups were 14 (70%) of 20 versus 71 (91%) of 78 (P = 0.023). The median OS in the HAART (-) group was 39 months (95% confidence interval [CI]: 0 to 89) and was not reached in the HAART (+) group (P = 0.0089). The median DFS in the HAART (-) group was 85 months (95% CI: 73 to 97) and was not reached in the HAART (+) group (P = 0.129). Factors independently associated with CR by logistic regression analysis were appropriate-for-stage therapy of HL, HAART, and baseline CD4 count > or =100 cells/microL. CR was the only factor independently associated with OS by Cox regression analysis.


CONCLUSIONS
The achievement of CR was independently associated with appropriate-for-stage therapy for HL, with HAART, and with a baseline CD4 count > or =100 cells/microL. The only variable independently associated with OS was the achievement of CR.
Berenguer
Juan
J
Hospital Gregorio Marañón, Madrid, Spain. juaberber@terra.es
Miralles
Pilar
P
Ribera
José María
JM
Rubio
Rafael
R
Valencia
Eulalia
E
Mahillo
Beatriz
B
Pintado
Vicente
V
Palacios
Rosario
R
Montes
María Luisa
ML
Téllez
María Jesús
MJ
La Cruz
José
J
Torre-Cisneros
Julián
J
Rodríguez-Arrondo
Francisco
F
Sepúlveda
María Antonia
MA
Gutiérrez
Félix
F
Peralta
Galo
G
Boix
Vicente
V
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy*; D008297:Male; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D012074:Remission Induction; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome