Abstract
BackgroundHuman Immuno-deficiency Virus (HIV) associated non-Hodgkin’s lymphoma (NHL) was a special group of disease, which manifests distinct clinical features and prognosis as compared with NHLs in patients without HIV. We performed this study to describe the clinical features of the disease and investigated the potential prognostic factors.MethodsHIV-infected patients who were newly diagnosed with NHL were enrolled in this study. The selection of anti-lymphoma treatment regimen was mainly dependent on the pathological subtypes of NHLs. Tumor response was reviewed and classified according to the International Workshop Criteria.ResultsA total of 78 patients were enrolled, among whom, 42 (53.8%) were with Diffuse large B cell Lymphoma (DLBCL), and 29 (37.2%) were with Burkitt lymphoma (BL). BL patients presented with higher risk features as compared with DLBCL in terms of numbers of extranodal diseases (P = 0.004) and poor Eastern cooperative oncology group (ECOG) score (P = 0.038). The estimated 2-year overall survival (OS) and progression free survival (PFS) rate was 74.3 ± 8.1%, 28.9 ± 11.0%, and 54.2 ± 8.1%, 19.2 ± 7.5% for DLBCL and BL, respectively. In multivariate analysis, international prognostic index (IPI) score was an independent prognostic factor for predicting both OS (OR = 2.172, 95% CI 1.579–2.987, P < 0.001) and PFS (OR = 1.838, 95% CI 1.406–2.402, P < 0.001).ConclusionsHIV associated NHLs represents a group of heterogeneous aggressive diseases with poor prognosis. IPI parameters were still effective in predicting the prognosis of HIV associated NHLs.
Highlights
Human Immuno-deficiency Virus (HIV) associated non-Hodgkin’s lymphoma (NHL) was a special group of disease, which manifests distinct clinical features and prognosis as compared with NHLs in patients without HIV
The Burkitt lymphoma (BL) patients presented with higher risk features as compared with diffuse large B cell lymphoma (DLBCL) patients in terms of numbers of extranodal disease (P = 0.004) and poor Eastern Cooperative Oncology Group (ECOG) score (P = 0.038), while age (P = 0.151), gender (P = 0.692) and CD4 cell count (P = 0.526) were distributed in the two groups
33% (25/78) of the patients was confirmed to be infected with HIV before lymphoma diagnosis. 22% (17/78) of them received ART with a median treatment exposure of 12 months before the diagnosis of lymphoma, whereas 78% (61/78) of the patients were ART-naïve. 67% (53/78) of the patients were simultaneously diagnosed of lymphoma and HIV
Summary
Human Immuno-deficiency Virus (HIV) associated non-Hodgkin’s lymphoma (NHL) was a special group of disease, which manifests distinct clinical features and prognosis as compared with NHLs in patients without HIV. Non-Hodgkin’s Lymphoma (NHL) is one of the most common types of malignancies with high morbidity and mortality in the patients who were infected by Human Immune-deficiency Virus (HIV) [1]. Chronic antigen stimulation (HIV infection) could lead to a polyclonal Bcell expansion and promotes the emergence of monoclonal B cells. Both germinal center B cell-like (GCB) active B cell subtype (ABC) could be observed in HIV associated DLBCL. A more comprehensive analysis incorporating above mentioned factors is warranted to give more precise stratification of HIV associated NHLs
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