HIV Status Does Not Influence Outcome in Patients With Classical Hodgkin Lymphoma Treated With Chemotherapy Using Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine in the Highly Active Antiretroviral Therapy Era
The prognosis of HIV-infected patients with non-Hodgkin lymphoma in the highly active antiretroviral therapy (HAART) era approaches that of the general population when they are treated with the same protocols. We analyzed the outcome of patients with Hodgkin lymphoma (HL) treated with doxorubicin, b...
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| Veröffentlicht in: | Journal of clinical oncology 2012-11, Vol.30 (33), p.4111-4116 |
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| creator | MONTOTO, Silvia SHAW, Kate YOUNG, Anna Marie TENANT-FLOWERS, Melinda ORKIN, Chloe JOHNSON, Margaret CHILTON, Daniella GRIBBEN, John G BOWER, Mark OKOSUN, Jessica GANDHI, Shreyans FIELDS, Paul WILSON, Andrew SHANYINDE, Milensu CWYNARSKI, Kate MARCUS, Robert DE VOS, Johannes |
| description | The prognosis of HIV-infected patients with non-Hodgkin lymphoma in the highly active antiretroviral therapy (HAART) era approaches that of the general population when they are treated with the same protocols. We analyzed the outcome of patients with Hodgkin lymphoma (HL) treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in the HAART era according to HIV serostatus to establish whether this also holds true for HL.
From 1997 to 2010, 224 patients newly diagnosed with HL, of whom 93 were HIV positive, were consecutively treated with ABVD chemotherapy. HIV-positive patients had more high-risk disease according to the International Prognostic Score (IPS) than HIV-negative patients (IPS≥3: 68% v 26%, respectively; P |
| doi_str_mv | 10.1200/JCO.2011.41.4193 |
| format | Article |
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From 1997 to 2010, 224 patients newly diagnosed with HL, of whom 93 were HIV positive, were consecutively treated with ABVD chemotherapy. HIV-positive patients had more high-risk disease according to the International Prognostic Score (IPS) than HIV-negative patients (IPS≥3: 68% v 26%, respectively; P<.001). Forty-seven HIV-positive patients had a CD4 count less than 200/μL, and 92 patients received HAART during chemotherapy.
The complete response rate was 74% for HIV-positive patients and 79% for HIV-negative patients (P=not significant). After a median follow-up of 60 months (range, 8 to 174 months), 23 patients (16 HIV-negative and seven HIV-positive patients) have experienced relapse at a median time of 6 months (range, 1 to 106 months). Five-year event-free survival (EFS) was 59% (95% CI, 47% to 70%) for HIV-positive patients and 66% (95% CI, 57% to 74%) for HIV-negative patients (P=not significant). Five-year overall survival (OS) was 81% (95% CI, 69% to 89%) and 88% (95% CI, 80% to 93%) for HIV-positive and HIV-negative patients, respectively (P=not significant). HIV status did not predict OS or EFS on multivariate analysis including IPS and HIV status.
This mature study demonstrates that HIV-positive patients with HL have more extensive disease with more adverse prognostic factors than HIV-negative patients, but when treated with ABVD, HIV infection does not adversely affect OS or EFS.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.2011.41.4193</identifier><identifier>PMID: 23045581</identifier><language>eng</language><publisher>Alexandria, VA: American Society of Clinical Oncology</publisher><subject>Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Antiretroviral Therapy, Highly Active - adverse effects ; Antiretroviral Therapy, Highly Active - methods ; Biological and medical sciences ; Bleomycin - administration & dosage ; Bleomycin - adverse effects ; Dacarbazine - administration & dosage ; Dacarbazine - adverse effects ; Disease-Free Survival ; Doxorubicin - administration & dosage ; Doxorubicin - adverse effects ; Female ; Fra ; HIV Infections - complications ; HIV Infections - drug therapy ; Hodgkin Disease - drug therapy ; Hodgkin Disease - pathology ; Hodgkin Disease - virology ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infectious diseases ; Lymphoma, AIDS-Related - drug therapy ; Lymphoma, AIDS-Related - pathology ; Lymphoma, AIDS-Related - virology ; Male ; Medical sciences ; Middle Aged ; Neoplasm Staging ; ORIGINAL REPORTS ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Tumors ; Vinblastine - administration & dosage ; Vinblastine - adverse effects ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Young Adult</subject><ispartof>Journal of clinical oncology, 2012-11, Vol.30 (33), p.4111-4116</ispartof><rights>2014 INIST-CNRS</rights><rights>2012 by American Society of Clinical Oncology 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-48ae825e6acf15799729d6a8e739c2ef3bbdf3483f84165cf2f0039ecadd76fd3</citedby><cites>FETCH-LOGICAL-c491t-48ae825e6acf15799729d6a8e739c2ef3bbdf3483f84165cf2f0039ecadd76fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3715,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26625612$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23045581$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MONTOTO, Silvia</creatorcontrib><creatorcontrib>SHAW, Kate</creatorcontrib><creatorcontrib>YOUNG, Anna Marie</creatorcontrib><creatorcontrib>TENANT-FLOWERS, Melinda</creatorcontrib><creatorcontrib>ORKIN, Chloe</creatorcontrib><creatorcontrib>JOHNSON, Margaret</creatorcontrib><creatorcontrib>CHILTON, Daniella</creatorcontrib><creatorcontrib>GRIBBEN, John G</creatorcontrib><creatorcontrib>BOWER, Mark</creatorcontrib><creatorcontrib>OKOSUN, Jessica</creatorcontrib><creatorcontrib>GANDHI, Shreyans</creatorcontrib><creatorcontrib>FIELDS, Paul</creatorcontrib><creatorcontrib>WILSON, Andrew</creatorcontrib><creatorcontrib>SHANYINDE, Milensu</creatorcontrib><creatorcontrib>CWYNARSKI, Kate</creatorcontrib><creatorcontrib>MARCUS, Robert</creatorcontrib><creatorcontrib>DE VOS, Johannes</creatorcontrib><title>HIV Status Does Not Influence Outcome in Patients With Classical Hodgkin Lymphoma Treated With Chemotherapy Using Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine in the Highly Active Antiretroviral Therapy Era</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>The prognosis of HIV-infected patients with non-Hodgkin lymphoma in the highly active antiretroviral therapy (HAART) era approaches that of the general population when they are treated with the same protocols. We analyzed the outcome of patients with Hodgkin lymphoma (HL) treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in the HAART era according to HIV serostatus to establish whether this also holds true for HL.
From 1997 to 2010, 224 patients newly diagnosed with HL, of whom 93 were HIV positive, were consecutively treated with ABVD chemotherapy. HIV-positive patients had more high-risk disease according to the International Prognostic Score (IPS) than HIV-negative patients (IPS≥3: 68% v 26%, respectively; P<.001). Forty-seven HIV-positive patients had a CD4 count less than 200/μL, and 92 patients received HAART during chemotherapy.
The complete response rate was 74% for HIV-positive patients and 79% for HIV-negative patients (P=not significant). After a median follow-up of 60 months (range, 8 to 174 months), 23 patients (16 HIV-negative and seven HIV-positive patients) have experienced relapse at a median time of 6 months (range, 1 to 106 months). Five-year event-free survival (EFS) was 59% (95% CI, 47% to 70%) for HIV-positive patients and 66% (95% CI, 57% to 74%) for HIV-negative patients (P=not significant). Five-year overall survival (OS) was 81% (95% CI, 69% to 89%) and 88% (95% CI, 80% to 93%) for HIV-positive and HIV-negative patients, respectively (P=not significant). HIV status did not predict OS or EFS on multivariate analysis including IPS and HIV status.
This mature study demonstrates that HIV-positive patients with HL have more extensive disease with more adverse prognostic factors than HIV-negative patients, but when treated with ABVD, HIV infection does not adversely affect OS or EFS.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active - adverse effects</subject><subject>Antiretroviral Therapy, Highly Active - methods</subject><subject>Biological and medical sciences</subject><subject>Bleomycin - administration & dosage</subject><subject>Bleomycin - adverse effects</subject><subject>Dacarbazine - administration & dosage</subject><subject>Dacarbazine - adverse effects</subject><subject>Disease-Free Survival</subject><subject>Doxorubicin - administration & dosage</subject><subject>Doxorubicin - adverse effects</subject><subject>Female</subject><subject>Fra</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>Hodgkin Disease - drug therapy</subject><subject>Hodgkin Disease - pathology</subject><subject>Hodgkin Disease - virology</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Lymphoma, AIDS-Related - drug therapy</subject><subject>Lymphoma, AIDS-Related - pathology</subject><subject>Lymphoma, AIDS-Related - virology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>ORIGINAL REPORTS</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Vinblastine - administration & dosage</subject><subject>Vinblastine - adverse effects</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Young Adult</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkk1vEzEQhlcIREvhzgn5guDQBH-s9-OCFNJCgiKCRFq4WV7vbNbtrh1sbyD8UH4PDgkFJEu2PM-872hmkuQpwWNCMX71frocU0zION2fkt1LTgmn-SjPOb-fnOKc0REp2JeT5JH3NxiTtGD8YXJCGU45L8hp8nM2v0afggyDRxcWPPpgA5qbphvAKEDLISjbA9IGfZRBgwkefdahRdNOeq-V7NDM1uvbGF_s-k1re4lWDmSA-si10NvQgpObHbry2qyjzXfrhkorbc7Rmw5sv_v9vNamiqpBGzhH0tToQirpKvkjfuwLiCpoptdtt0MTFfQW0MQE7SA4u9UuVrI62lw6-Th50MjOw5PjfZZcvb1cTWejxfLdfDpZjFRakjBKCwkF5ZBJ1RCel2VOyzqTBeSsVBQaVlV1w2LTmiIlGVcNbTBmJShZ13nW1OwseX3Q3QxVD7WKDYqViI3TvXQ7YaUW_0eMbsXabgVnFBdFGQVeHgWc_TqAD6LXXkHXSQN28IJwTjJWlCmJKD6gylnvHTR3NgSL_TqIuA5ivw4i3Z-SxZRn_5Z3l_Bn_hF4fgSkj8NsnDRK-79cllGeERq5FweujQP4FpsufC-7LspScaMsw4KxaEkI-wXx7dBH</recordid><startdate>20121120</startdate><enddate>20121120</enddate><creator>MONTOTO, Silvia</creator><creator>SHAW, Kate</creator><creator>YOUNG, Anna Marie</creator><creator>TENANT-FLOWERS, Melinda</creator><creator>ORKIN, Chloe</creator><creator>JOHNSON, Margaret</creator><creator>CHILTON, Daniella</creator><creator>GRIBBEN, John G</creator><creator>BOWER, Mark</creator><creator>OKOSUN, Jessica</creator><creator>GANDHI, Shreyans</creator><creator>FIELDS, Paul</creator><creator>WILSON, Andrew</creator><creator>SHANYINDE, Milensu</creator><creator>CWYNARSKI, Kate</creator><creator>MARCUS, Robert</creator><creator>DE VOS, Johannes</creator><general>American Society of Clinical Oncology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20121120</creationdate><title>HIV Status Does Not Influence Outcome in Patients With Classical Hodgkin Lymphoma Treated With Chemotherapy Using Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine in the Highly Active Antiretroviral Therapy Era</title><author>MONTOTO, Silvia ; SHAW, Kate ; YOUNG, Anna Marie ; TENANT-FLOWERS, Melinda ; ORKIN, Chloe ; JOHNSON, Margaret ; CHILTON, Daniella ; GRIBBEN, John G ; BOWER, Mark ; OKOSUN, Jessica ; GANDHI, Shreyans ; FIELDS, Paul ; WILSON, Andrew ; SHANYINDE, Milensu ; CWYNARSKI, Kate ; MARCUS, Robert ; DE VOS, Johannes</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-48ae825e6acf15799729d6a8e739c2ef3bbdf3483f84165cf2f0039ecadd76fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Antiretroviral Therapy, Highly Active - adverse effects</topic><topic>Antiretroviral Therapy, Highly Active - methods</topic><topic>Biological and medical sciences</topic><topic>Bleomycin - administration & dosage</topic><topic>Bleomycin - adverse effects</topic><topic>Dacarbazine - administration & dosage</topic><topic>Dacarbazine - adverse effects</topic><topic>Disease-Free Survival</topic><topic>Doxorubicin - administration & dosage</topic><topic>Doxorubicin - adverse effects</topic><topic>Female</topic><topic>Fra</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>Hodgkin Disease - drug therapy</topic><topic>Hodgkin Disease - pathology</topic><topic>Hodgkin Disease - virology</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Lymphoma, AIDS-Related - drug therapy</topic><topic>Lymphoma, AIDS-Related - pathology</topic><topic>Lymphoma, AIDS-Related - virology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>ORIGINAL REPORTS</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Vinblastine - administration & dosage</topic><topic>Vinblastine - adverse effects</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MONTOTO, Silvia</creatorcontrib><creatorcontrib>SHAW, Kate</creatorcontrib><creatorcontrib>YOUNG, Anna Marie</creatorcontrib><creatorcontrib>TENANT-FLOWERS, Melinda</creatorcontrib><creatorcontrib>ORKIN, Chloe</creatorcontrib><creatorcontrib>JOHNSON, Margaret</creatorcontrib><creatorcontrib>CHILTON, Daniella</creatorcontrib><creatorcontrib>GRIBBEN, John G</creatorcontrib><creatorcontrib>BOWER, Mark</creatorcontrib><creatorcontrib>OKOSUN, Jessica</creatorcontrib><creatorcontrib>GANDHI, Shreyans</creatorcontrib><creatorcontrib>FIELDS, Paul</creatorcontrib><creatorcontrib>WILSON, Andrew</creatorcontrib><creatorcontrib>SHANYINDE, Milensu</creatorcontrib><creatorcontrib>CWYNARSKI, Kate</creatorcontrib><creatorcontrib>MARCUS, Robert</creatorcontrib><creatorcontrib>DE VOS, Johannes</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MONTOTO, Silvia</au><au>SHAW, Kate</au><au>YOUNG, Anna Marie</au><au>TENANT-FLOWERS, Melinda</au><au>ORKIN, Chloe</au><au>JOHNSON, Margaret</au><au>CHILTON, Daniella</au><au>GRIBBEN, John G</au><au>BOWER, Mark</au><au>OKOSUN, Jessica</au><au>GANDHI, Shreyans</au><au>FIELDS, Paul</au><au>WILSON, Andrew</au><au>SHANYINDE, Milensu</au><au>CWYNARSKI, Kate</au><au>MARCUS, Robert</au><au>DE VOS, Johannes</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HIV Status Does Not Influence Outcome in Patients With Classical Hodgkin Lymphoma Treated With Chemotherapy Using Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine in the Highly Active Antiretroviral Therapy Era</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2012-11-20</date><risdate>2012</risdate><volume>30</volume><issue>33</issue><spage>4111</spage><epage>4116</epage><pages>4111-4116</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>The prognosis of HIV-infected patients with non-Hodgkin lymphoma in the highly active antiretroviral therapy (HAART) era approaches that of the general population when they are treated with the same protocols. We analyzed the outcome of patients with Hodgkin lymphoma (HL) treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in the HAART era according to HIV serostatus to establish whether this also holds true for HL.
From 1997 to 2010, 224 patients newly diagnosed with HL, of whom 93 were HIV positive, were consecutively treated with ABVD chemotherapy. HIV-positive patients had more high-risk disease according to the International Prognostic Score (IPS) than HIV-negative patients (IPS≥3: 68% v 26%, respectively; P<.001). Forty-seven HIV-positive patients had a CD4 count less than 200/μL, and 92 patients received HAART during chemotherapy.
The complete response rate was 74% for HIV-positive patients and 79% for HIV-negative patients (P=not significant). After a median follow-up of 60 months (range, 8 to 174 months), 23 patients (16 HIV-negative and seven HIV-positive patients) have experienced relapse at a median time of 6 months (range, 1 to 106 months). Five-year event-free survival (EFS) was 59% (95% CI, 47% to 70%) for HIV-positive patients and 66% (95% CI, 57% to 74%) for HIV-negative patients (P=not significant). Five-year overall survival (OS) was 81% (95% CI, 69% to 89%) and 88% (95% CI, 80% to 93%) for HIV-positive and HIV-negative patients, respectively (P=not significant). HIV status did not predict OS or EFS on multivariate analysis including IPS and HIV status.
This mature study demonstrates that HIV-positive patients with HL have more extensive disease with more adverse prognostic factors than HIV-negative patients, but when treated with ABVD, HIV infection does not adversely affect OS or EFS.</abstract><cop>Alexandria, VA</cop><pub>American Society of Clinical Oncology</pub><pmid>23045581</pmid><doi>10.1200/JCO.2011.41.4193</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of clinical oncology, 2012-11, Vol.30 (33), p.4111-4116 |
| issn | 0732-183X 1527-7755 |
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| source | MEDLINE; American Society of Clinical Oncology Online Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - adverse effects Antineoplastic Combined Chemotherapy Protocols - therapeutic use Antiretroviral Therapy, Highly Active - adverse effects Antiretroviral Therapy, Highly Active - methods Biological and medical sciences Bleomycin - administration & dosage Bleomycin - adverse effects Dacarbazine - administration & dosage Dacarbazine - adverse effects Disease-Free Survival Doxorubicin - administration & dosage Doxorubicin - adverse effects Female Fra HIV Infections - complications HIV Infections - drug therapy Hodgkin Disease - drug therapy Hodgkin Disease - pathology Hodgkin Disease - virology Human immunodeficiency virus Human viral diseases Humans Infectious diseases Lymphoma, AIDS-Related - drug therapy Lymphoma, AIDS-Related - pathology Lymphoma, AIDS-Related - virology Male Medical sciences Middle Aged Neoplasm Staging ORIGINAL REPORTS Prognosis Retrospective Studies Treatment Outcome Tumors Vinblastine - administration & dosage Vinblastine - adverse effects Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Young Adult |
| title | HIV Status Does Not Influence Outcome in Patients With Classical Hodgkin Lymphoma Treated With Chemotherapy Using Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine in the Highly Active Antiretroviral Therapy Era |
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