HL-323: Outcomes of First-Line Treatment in Patients with Advanced Clinical Stage Classic Hodgkin Lymphoma and Human Immunodeficiency Virus Infection

Abstract

Context Patients with human immunodeficiency virus (HIV) have a higher incidence of advanced-stage classic Hodgkin lymphoma (cHL) than those without HIV. Outcomes with first-line ABVD chemotherapy in these patients have yet to be well defined. Objective To determine the outcomes of advanced-stage HIV-cHL and compare them with those of non-HIV-cHL. Design Observational, descriptive study from August 2004 to December 2018. Clinical features were compared by standard statistical methods. Overall survival (OS) and relapse-free survival (RFS) were calculated with Kaplan-Meier methodology. Setting Studied population comes from a national reference center. Patients or other participants Twenty-one patients with HIV-cHL (based on the 2016 WHO criteria), all male with advanced clinical stage disease, were compared with 58 non-HIV-cHL patients with the same characteristics. Interventions All patients received ABVD chemotherapy. Main outcome measures Complete response (CR), OS, and RFS were determined. Results The mean age was 42.9 (± 10.88) years in HIV-cHL and 45.1 (± 17.56) years in non-HIV-cHL (p = 0.50). There was a significantly lower leucocyte count in HIV-cHL (4.6×103 cells/mL) compared with non-HIV-cHL (6.7×103 cells/mL) (p = 0.02). In the monocyte line, HIV-cHL had lower absolute counts (340 cells/mL) than non-HIV-cHL (708 cells/mL) (p = 0.01). In HIV-positive patients, 40 months was the median time for cHL diagnosis. The median CD4 cell count was 109 cells/mL. The median follow-up time for HIV-cHL was 10 months, shorter than the median follow-up time for non-HIV-cHL (45 months) (p = 0.01). CR was documented in 61.1% of HIV-cHL and in 66.1% of non-HIV-cHL (p = 0.77). RFS was 36.5 months for all patients, being less for HIV-cHL (24 months) compared with non-HIV-cHL (51 months) (p = 0.03). The OS median at the time of last follow-up had not yet been reached in all patients. At last follow-up, 22 (27.8%) patients had died, 6 (28.6%) HIV-cHL and 16 (27.6%) non-HIV-cHL (p = 1.00). Conclusions Outcomes were similar in both groups. There was no difference observed in the likelihood of achieving CR. Hence, the prognosis of advanced clinical stage HIV-cHL is similar to non-HIV-cHL patients treated with first-line ABVD chemotherapy.