Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: A Peruvian experience

Luis Ernesto Cuellar, Andrea Anampa-Guzmán, Alexis Manuel Holguín, Juan Velarde, Diana Portillo-Alvarez, Marco Antonio Zuñiga-Ninaquispe, Esther Rosa Luna-Reyes, Jule Vásquez, Joanne M Jeter, Karen Marie Winkfield

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1 Scopus citations

Abstract

Background: Non-Hodgkin lymphoma (NHL) is the most common cancer in people with HIV. Although 95% of HIV patients are in developing countries like Peru, the majority of these studies have been conducted in developed countries. In this study we aim to evaluate prognostic factors associated with outcomes in HIV positive patients undergoing systemic therapy for treatment of NHL. Methods: This retrospective study includes patients with NHL seen in the Instituto Nacional de Enfermedades Neoplasicas (INEN) between 2004 to 2014. Patients were divided into two groups: antiretroviral therapy (ART) -naïve (n = 34) and those previously treated, ART-exposed (n = 13), at the time of diagnosis. All patients received chemotherapy and ART. The medical records were reviewed. Data were analyzed using t-test and chi-square test. Survival curves were estimated by the Kaplan-Meier method and comparison was done by log-rank test. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model. Results: All ART-exposed patients were from the capital city (p = 0.039); they had significantly lower hemoglobin levels compared to ART-naïve patients (p = 0.026). The median OS was 47.7 months with a 5-yr OS of 36.1%. The median OS for ART naïve patients was significantly higher than that for ART-exposed patients (57.05 and 21.09 months, respectively; p = 0.018). Advanced stage and low serum albumin were associated with lower OS in both groups. Age > 60 was associated with worse outcomes in the ART-naïve cohort. Conclusions: Advanced stage, low serum albumin and previous ART treatment were the primary prognostic factors associated with poorer outcomes in patients with NHL and HIV infection. In ART-naïve patients, age > 60 was associated with worse outcomes but in this cohort, older patients still had better overall outcomes than ART-exposed patients.

Original languageEnglish (US)
Article number27
JournalInfectious Agents and Cancer
Volume13
Issue number1
DOIs
StatePublished - Jul 31 2018
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Infectious Diseases
  • Cancer Research

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    Cuellar, L. E., Anampa-Guzmán, A., Holguín, A. M., Velarde, J., Portillo-Alvarez, D., Zuñiga-Ninaquispe, M. A., Luna-Reyes, E. R., Vásquez, J., Jeter, J. M., & Winkfield, K. M. (2018). Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: A Peruvian experience. Infectious Agents and Cancer, 13(1), [27]. https://doi.org/10.1186/s13027-018-0200-y