Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience
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 wi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | Infectious Agents and Cancer |
| Online Access: | http://link.springer.com/article/10.1186/s13027-018-0200-y |
| _version_ | 1819261881824575488 |
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| author | 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 Marie Jeter Karen Marie Winkfield |
| author_facet | 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 Marie Jeter Karen Marie Winkfield |
| author_sort | Luis Ernesto Cuellar |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-23T19:48:51Z |
| format | Article |
| id | doaj.art-fab4be1de1d4442ca3d7bc266b967fb2 |
| institution | Directory Open Access Journal |
| issn | 1750-9378 |
| language | English |
| last_indexed | 2024-12-23T19:48:51Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Agents and Cancer |
| spelling | doaj.art-fab4be1de1d4442ca3d7bc266b967fb22022-12-21T17:33:28ZengBMCInfectious Agents and Cancer1750-93782018-07-011311610.1186/s13027-018-0200-yPrognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experienceLuis Ernesto Cuellar0Andrea Anampa-Guzmán1Alexis Manuel Holguín2Juan Velarde3Diana Portillo-Alvarez4Marco Antonio Zuñiga-Ninaquispe5Esther Rosa Luna-Reyes6Jule Vásquez7Joanne Marie Jeter8Karen Marie Winkfield9Instituto Nacional de Enfermedades NeoplasicasFacultad de Medicina Humana, Universidad Nacional Mayor de San MarcosInstituto Nacional de Enfermedades NeoplasicasInstituto Nacional de Enfermedades NeoplasicasInstituto Nacional de Enfermedades NeoplasicasFacultad de Medicina Humana, Universidad Nacional Mayor de San MarcosInstituto Nacional de Enfermedades NeoplasicasInstituto Nacional de Enfermedades NeoplasicasDivisions of Human Genetics and Medical Oncology, The Ohio State UniversityDepartment of Radiation Oncology, Wake Forest Baptist Medical CenterAbstract 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.http://link.springer.com/article/10.1186/s13027-018-0200-y |
| spellingShingle | 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 Marie Jeter Karen Marie Winkfield Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience Infectious Agents and Cancer |
| title | Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience |
| title_full | Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience |
| title_fullStr | Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience |
| title_full_unstemmed | Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience |
| title_short | Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience |
| title_sort | prognostic factors in hiv positive patients with non hodgkin lymphoma a peruvian experience |
| url | http://link.springer.com/article/10.1186/s13027-018-0200-y |
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