ISSN 1866-8836
Клеточная терапия и трансплантация

AW-01. The results of a retrospective multicenter study: epidemiology of HIV-related Non-Hodgkin lympoma

Аndrey М. Chekalov1, Marina О. Popova1, Ivan V. Tsygankov1, Yulia А. Rogacheva1, Nikita P. Volkov1, Anastasia V. Beynarovich1, Kirill V. Lepik1, Мarina V. Demchenkova2, М. V. Grigorieva2, Тatyana V. Schneider3, Yulia V. Kopeikina3, Vsevolod G. Potapenko4, Nadezhda V. Medvedeva4, Ilya S. Zyuzgin5, Мaria А. Kolesnikova6, Тatyana I. Pospelova6, Еlena Е. Zinina7, Аlexander А. Myasnikov8, Кamil D. Kaplanov9, Тatyana I. Ksenzova10, Stella S. Zola11, Еlena S. Pavlyuchenko12, Natalya B. Mikhailova1, Vadim V. Baykov1, Аlexander D. Kulagin1

1 RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
2 Irkutsk Regional Cancer Center, Irkutsk, Russia
3 Leningrad Regional Clinical Hospital, St. Petersburg, Russia
4 Municipal Educational Hospital №31, St. Petersburg, Russia
5 N. Petrov National Medicine Research Center of Oncology, St. Petersburg, Russia
6 Municipal Clinical Hospital No. 2 of Novosibirsk Region, Novosibirsk, Russia
7 Surgut’s Clinical Hospital, Surgut, Russia
8 V. A. Baranov Republican Hospital, Petrozavodsk, Republic of Karelia, Russia
9 Volgograd Regional Clinical Oncology Dispensary, Volgograd, Russia
10 Regional Clinical Hospital, Tumen, Russia
11 Clinic of Professional Pathology and Haematology, Saratov State Medical University, Saratov, Russia
12 II Mechnikov North-Western State Medical University, St. Petersburg, Russia


Correspondence:
Dr. Marina O. Popova, e-mail: marina.popova.spb@gmail.com

doi 10.18620/ctt-1866-8836-2021-10-3-1-148

Summary

The patients with HIV infection have a significantly higher risk of developing cancer, especially non-Hodgkin lymphomas (NHL) than the general population. In the era of antiretroviral therapy (ART) the cancer risk and the mortality has been decreased. The ART allow to treat HIV-infected patients with lymphomas with protocols for patients in general population. Our aim was to study epidemiology and evaluate the efficacy of first-line therapy for NHL in HIV-infected individuals in a multicenter study.

Patients and methods

The study included 210 patients with NHL and HIV who received therapy at 12 Russian centers in the period from 2006 to 2020. The median follow-up was 7 months (1-103). Overall survival (OS) and progression-free survival (PFS) were analyzed within two years of starting first-line therapy using the Kaplan-Meier method.

Results

Types of HIV-related NHL were: diffuse large B-cell lymphoma (DLBCL) – 59% (n=121), Burkitt’s lymphoma (BL) – 18% (n=38), plasmablastic lymphoma (PBL) – 11 % (n=23), other types of lymphomas – 12% (n=24). The median age was 39 years (21-69), men – 62% (n=130), women – 39% (n=80). The advanced stage of the disease was observed (3-4 Ann Arbor) in 82% of patients, B-symptoms at the onset of the disease – 55%, CNS involvement – 20%. The majority of patients (94.1%) received ART, the median number of CD4+ cells/μL at the onset of lymphoma was 221.8 (17-1105). As the first line of therapy, patients with NHL received predominantly EPOCH-like (48.5%) and CHOP-like (35.7%) regimens. Rituximab-containing regimens had been used in 57% of NHL cases. The median of chemotherapy courses was 4 (1-8). Structure of response to first-line therapy were: complete response (CR) – 46.6%, partial response (PR) – 31.5%, disease stabilization (SD) – 6.2%, disease progression (PD) – 15.8%. OS in the study group was 67%, PFS – 50% (median PFS – 18.7 months). Performance status ECOG≥2 significantly decreased 2-year OS and PFS (p=0.001), CNS disease at the onset of the lymphoma significantly decreased PFS (56% vs 29%, p=0.008). In the group of patients with CD20+ B-cell lymphomas, the addition of rituximab significantly improved 2-year PFS (57% vs 49%, p=0.05). Age, B-symptoms, and disease stage did not significantly affect OS and PFS.

Conclusion

Diffuse large B-cell lymphoma is the most common HIV-related lymphoma. HIV-related NHL are diagnosed at an advanced stage of the disease. The overall response to first-line therapy was 79%. Performance status ECOG≥2, CNS disease significantly worsened the outcome. The addition of rituximab in the therapy of CD20+ B-cell lymphomas, improve PFS. Age, B-symptoms, and disease stage do not significantly affect the outcome of therapy.

Keywords

Non-Hodgkin lymphoma, HIV infection, diffuse large B-cell lymphoma, rituximab, CNS disease, ECOG, first-line therapies, multicenter study.


Volume 10, Number 3
09/30/2021

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doi 10.18620/ctt-1866-8836-2021-10-3-1-148

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