Lymphoma-associated mortality in the German HIV-lymphoma cohort study.
2016; Lippincott Williams & Wilkins; Volume: 34; Issue: 15_suppl Linguagem: Inglês
10.1200/jco.2016.34.15_suppl.7550
ISSN1527-7755
AutoresMarcus Hentrich, Christoph Wyen, Daniel Gillor, Markus Mueller, Albrecht Stoehr, Alexander Schultze, Björn‐Erik Ole Jensen, Jan‐Christian Wasmuth, Timo Wolf, Jan Siehl, Mark Oette, Ninon Taylor, Manfred Hensel, Gerd Fätkenheuer, Philipp Schommers, Christian Hoffmann,
Tópico(s)Viral-associated cancers and disorders
Resumo7550 Background: Since the introduction of combination antiretroviral therapy (ART) the outcome of HIV-associated lymphoma has significantly improved. However, aggressive lymphomas remain the most frequent AIDS-defining event leading to death. We aimed to analyse lymphoma-related mortality in the German HIV-Lymphoma Cohort Study. Methods: This prospective multicenter cohort study includes adult HIV- 1 infected patients with biopsy or cytologically proven HIV-related lymphoma diagnosed at 33 participating centers in Germany and Austria since January 2005. Data on HIV-infection and lymphoma characteristics, treatments and outcomes recorded until December 2014 were analyzed. Pts with T-cell lymphomas, indolent lymphomas and primary central nervous system lymphomas were excluded from the present analysis. Results: Of 499 pts (463 males, 36 females) 394 had aggressive NHL and 105 HL. At the time of lymphoma diagnosis the median age was 44.7 years (range, 22–74.7) and the median CD4-cell count was 210/μl (0–1586). 344 of 499 pts (69%) were diagnosed with advanced stage (III/IV) disease. 214 pts (43%) were ART-naïve, 175 pts (35%) had a viral load below the detection limit of < 50 HIV RNA copies/ml at lymphoma diagnosis while on ART, and 110 pts (22%) had a viral load > 50 copies/ml while on ART or while discontinuing ART. After a median follow-up of 1.8 years 25 of 105 HL (24%) and 122 of 394 NHL pts (31%) have died with an overall death rate of 30% (147/499). 84 of 147 pts (57%) died of relapsed/refractory lymphoma, 75 of 122 pts with NHL (62%) and 9 of 25 pts with HL (36%). In 30 of 147 pts (20%) the cause of death were infections during or shortly after primary chemotherapy (7/25 pts with HL [28%] and 23/122 of pts with NHL [19%]). CD4-cell count was 164/μl in pts who died of infections compared to 293/μl in pts alive (P< 0.001). Further causes of death were secondary malignancies (n = 6; 4%), AIDS-defining events other than NHL (n = 6; 4%) including 4 cases of progressive multifocal leukoencephalopathy, and miscellaneous (n = 21; 14%). Conclusions: HIV-related lymphomas mainly occur in ART-naïve or insufficiently treated patients. The major cause of death is relapsed/refractory lymphoma followed by infections during or shortly after primary chemotherapy.
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