Serbian lymphoma study group (SLG): The prognosis of AIDS-related non-Hodgkin's lymphoma

Abstract

Background The majority of patients with AIDS-related non-Hodgkin's lymphoma (ARL) present with advanced disease, aggressive histological type, B-symptoms, and often with an extranodal localization. The prognosis is generally poor. The use of highly active antiretroviral therapy (HAART), in combination with chemotherapy, has improved the outcome of ARL. Aims The aims of this study were to detect prognostic factors for patients with ARL and estimate efficacy of concomitant chemotherapy and HAART on overall survival (OS) of these patients. Also, two different chemotherapy regimens have been tested: low dose (ld) mBACOD and CHOP. Methods The study series involved 28 patients with ARL treated at the Clinical Center of Serbia in Belgrade during the period 1996–2006. Twenty-six patients had an aggressive type of lymphoma while 2 had an indolent type. Nineteen patients were treated with chemotherapy, 10 with ld mBACOD and 9 with CHOP. Concomitant HAART and chemotherapy were used in 14 patients. Results This study demonstrated that significant factors for OS in patients with ARL were the high International Prognostic Index ( P = 0.019), previous AIDS event ( P = 0.04), aggressive histological type of NHL ( P = 0.007) and extranodal disease ( P = 0.04). The usage of concomitant HAART and chemotherapy had significant effect on median survival (90 months), compared with chemotherapy alone (10 months) ( P = 0.0002). The patients treated with CHOP had a better response than patients treated with ld mBACOD, but this difference was not significant. Conclusions Our data suggest that aggressive presentation of ARL implicates the need not only for more intensive chemotherapy regimens, but the concomitant usage of HAART, which should result in higher rates of OS in ARL patients.