Revista medica de Chile · 2012
[HIV-related lymphoma in a public hospital in Chile. Analysis of 55 cases].
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Cabrera María Elena, Silva Guillermo, Soto Andrés, Roselló Rodrigo, Castro Constanza, Martínez Virginia, Ballesteros Juan, Blamey Rodrigo, Garreaud Claudia
Аннотация
BACKGROUND: Cancer is the third cause of death in patients infected with human immunodeficiency virus (HIV) and lymphoma is the most common type.
AIM: To describe the clinical characteristics, histology, risk factors and prognosis of these patients, in a Chilean public hospital in Chile.
MATERIAL AND METHODS: Records of 55 patients (45 males) aged between 23 and 67 years with lymphoma and HIV positive serology, diagnosed between 1992-2008, were reviewed.
RESULTS: Six patients (11%) had Hodgkin lymphoma (HL) and the rest, non-Hodgkin lymphoma (NHL). B-cell phenotype constituted 83.7% of NHL cases. The most common subtypes of all the lymphoma were diffuse large B cell lymphoma in 24 cases (43.6%), Burkitt lymphoma in 12 cases (21.8%), and plasmablastic lymphoma in 5 cases (9.1%). Thirty five patients (64%) underwent curative intended chemotherapy (CT) concomitantly with highly active antiretroviral therapy (HAART). Three year survival of the whole cohort was 27%. By multivariate analysis, the most important prognostic factors for long term survival, were complete responses to CT, (p < 0.01) and a low international prognostic index (IPI) score for NHL, (p = 0.01). HAART, histologic subtype and CD4 lymphocyte count at diagnosis, did not influence survival.
CONCLUSIONS: The most important prognostic factors for HIV patients with lymphoma, were achieving CR with CT and low IPI score. Prognosis remains poor, even with HAART therapy.
AIM: To describe the clinical characteristics, histology, risk factors and prognosis of these patients, in a Chilean public hospital in Chile.
MATERIAL AND METHODS: Records of 55 patients (45 males) aged between 23 and 67 years with lymphoma and HIV positive serology, diagnosed between 1992-2008, were reviewed.
RESULTS: Six patients (11%) had Hodgkin lymphoma (HL) and the rest, non-Hodgkin lymphoma (NHL). B-cell phenotype constituted 83.7% of NHL cases. The most common subtypes of all the lymphoma were diffuse large B cell lymphoma in 24 cases (43.6%), Burkitt lymphoma in 12 cases (21.8%), and plasmablastic lymphoma in 5 cases (9.1%). Thirty five patients (64%) underwent curative intended chemotherapy (CT) concomitantly with highly active antiretroviral therapy (HAART). Three year survival of the whole cohort was 27%. By multivariate analysis, the most important prognostic factors for long term survival, were complete responses to CT, (p < 0.01) and a low international prognostic index (IPI) score for NHL, (p = 0.01). HAART, histologic subtype and CD4 lymphocyte count at diagnosis, did not influence survival.
CONCLUSIONS: The most important prognostic factors for HIV patients with lymphoma, were achieving CR with CT and low IPI score. Prognosis remains poor, even with HAART therapy.