Limited comparative data exist for the treatment of HIV-associated non-Hodgkin lymphoma. We analyzed pooled individual patient data for 1546 patients from 19 prospective clinical trials to assess treatment-specific factors (type of chemotherapy, rituximab, and concurrent combination antiretroviral [cART] use) and their influence on the outcomes complete response (CR), progression free survival (PFS), and overall survival (OS). In our analysis, rituximab was associated with a higher CR rate (odds ratio [OR] 2.89; P <.001), improved PFS (hazard ratio [HR] 0.50; P <.001), and OS (HR 0.51; P <.0001). Compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), initial therapy with more dose-intense regimens resulted in better CR rates (ACVBP [doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisolone]: OR 1.70; P <.04), PFS (ACVBP: HR 0.72; P 5.049; "intensive regimens": HR 0.35; P <.001) and OS ("intensive regimens": HR 0.54; P <.001). Infusional etoposide, prednisone, infusional vincristine, infusional doxorubicin, and cyclophosphamide (EPOCH) was associated with significantly better OS in diffuse large B-cell lymphoma (HR 0.33; P 5.03). Concurrent use of cART was associated with improved CR rates (OR 1.89; P 5.005) and trended toward improved OS (HR 0.78; P 5.07). These findings provide supporting evidence for current patterns of care where definitive evidence is unavailable.
ASJC Scopus subject areas
- Cell Biology