Barta, Stefan K., Xue, Xiaonan, Wang, Dan, Tamari, Roni, Lee, Jeannette Y., Mounier, Nicolas ORCID: 0000-0002-0707-426X, Kaplan, Lawrence D., Ribera, Josep-Maria, Spina, Michele ORCID: 0000-0001-6576-8182, Tirelli, Umberto, Weiss, Rudolf, Galicier, Lionel, Boue, Francois, Wilson, Wyndham H., Wyen, Christoph, Oriol, Albert ORCID: 0000-0001-6804-2221, Navarro, Jose-Tomas, Dunleavy, Kieron, Little, Richard F., Ratner, Lee ORCID: 0000-0003-2744-7294, Garcia, Olga, Morgades, Mireia ORCID: 0000-0003-0295-2534, Remick, Scot C., Noy, Ariela ORCID: 0000-0002-3001-4898 and Sparano, Joseph A. (2013). Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: a pooled analysis of 1546 patients. Blood, 122 (19). S. 3251 - 3263. WASHINGTON: AMER SOC HEMATOLOGY. ISSN 1528-0020

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Abstract

Limited comparative data exist for the treatment of HIV-associated non-Hodgkin lymphoma. We analyzed pooled individual patient data for 1546 patients from 19 prospective clinical trials to assess treatment-specific factors (type of chemotherapy, rituximab, and concurrent combination antiretroviral [cART] use) and their influence on the outcomes complete response (CR), progression free survival (PFS), and overall survival (OS). In our analysis, rituximab was associated with a higher CR rate (odds ratio [OR] 2.89; P < .001), improved PFS (hazard ratio [HR] 0.50; P < .001), and OS (HR 0.51; P < .0001). Compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), initial therapy with more dose-intense regimens resulted in better CR rates (ACVBP [doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisolone]: OR 1.70; P < .04), PFS (ACVBP: HR 0.72; P = .049; intensive regimens: HR 0.35; P < .001) and OS (intensive regimens: HR 0.54; P < .001). Infusional etoposide, prednisone, infusional vincristine, infusional doxorubicin, and cyclophosphamide (EPOCH) was associated with significantly better OS in diffuse large B-cell lymphoma (HR 0.33; P = .03). Concurrent use of cART was associated with improved CR rates (OR 1.89; P = .005) and trended toward improved OS (HR 0.78; P = .07). These findings provide supporting evidence for current patterns of care where definitive evidence is unavailable.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Barta, Stefan K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Xue, XiaonanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wang, DanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tamari, RoniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lee, Jeannette Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mounier, NicolasUNSPECIFIEDorcid.org/0000-0002-0707-426XUNSPECIFIED
Kaplan, Lawrence D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ribera, Josep-MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spina, MicheleUNSPECIFIEDorcid.org/0000-0001-6576-8182UNSPECIFIED
Tirelli, UmbertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weiss, RudolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Galicier, LionelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boue, FrancoisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wilson, Wyndham H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wyen, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oriol, AlbertUNSPECIFIEDorcid.org/0000-0001-6804-2221UNSPECIFIED
Navarro, Jose-TomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dunleavy, KieronUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Little, Richard F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ratner, LeeUNSPECIFIEDorcid.org/0000-0003-2744-7294UNSPECIFIED
Garcia, OlgaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morgades, MireiaUNSPECIFIEDorcid.org/0000-0003-0295-2534UNSPECIFIED
Remick, Scot C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Noy, ArielaUNSPECIFIEDorcid.org/0000-0002-3001-4898UNSPECIFIED
Sparano, Joseph A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-472118
DOI: 10.1182/blood-2013-04-498964
Journal or Publication Title: Blood
Volume: 122
Number: 19
Page Range: S. 3251 - 3263
Date: 2013
Publisher: AMER SOC HEMATOLOGY
Place of Publication: WASHINGTON
ISSN: 1528-0020
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
B-CELL LYMPHOMA; ACTIVE ANTIRETROVIRAL THERAPY; ORAL COMBINATION CHEMOTHERAPY; VIRUS-INFECTION STATUS; DOSE-ADJUSTED EPOCH; PHASE-II TRIAL; PLUS RITUXIMAB; INFUSIONAL CYCLOPHOSPHAMIDE; G-CSF; CHOPMultiple languages
HematologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/47211

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