Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: A pooled analysis of 1546 patients

Stefan K. Barta, Xiaonan Xue, Dan Wang, Roni Tamari, Jeannette Y. Lee, Nicolas Mounier, Lawrence D. Kaplan, Josep Maria Ribera, Michele Spina, Umberto Tirelli, Rudolf Weiss, Lionel Galicier, Francois Boue, Wyndham H. Wilson, Christoph Wyen, Albert Oriol, José Tomás Navarro, Kieron Dunleavy, Richard F. Little, Lee RatnerOlga Garcia, Mireia Morgades, Scot C. Remick, Ariela Noy, Joseph A. Sparano

Research output: Contribution to journalArticle

96 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3251-3262
Number of pages12
JournalBlood
Volume122
Issue number19
DOIs
StatePublished - Nov 7 2013

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Barta, S. K., Xue, X., Wang, D., Tamari, R., Lee, J. Y., Mounier, N., Kaplan, L. D., Ribera, J. M., Spina, M., Tirelli, U., Weiss, R., Galicier, L., Boue, F., Wilson, W. H., Wyen, C., Oriol, A., Navarro, J. T., Dunleavy, K., Little, R. F., ... Sparano, J. A. (2013). Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: A pooled analysis of 1546 patients. Blood, 122(19), 3251-3262. https://doi.org/10.1182/blood-2013-04-498964