Prognostic factors for advanced-stage human immunodeficiency virus-associated classical Hodgkin lymphoma treated with doxorubicin, bleomycin, vinblastine, and dacarbazine plus combined antiretroviral therapy: A multi-institutional retrospective study

HIV-Associated Hodgkin Lymphoma in the cART Era Study Group

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21 Citations (Scopus)

Abstract

BACKGROUND: The treatment and outcomes of patients with human immunodeficiency virus (HIV)-associated Hodgkin lymphoma (HL) continue to evolve. The International Prognostic Score (IPS) is used to predict the survival of patients with advanced-stage HL, but it has not been validated in patients with HIV infection. METHODS: This was a multi-institutional, retrospective study of 229 patients with HIV-associated, advanced-stage, classical HL who received doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus combination antiretroviral therapy. Their clinical characteristics were presented descriptively, and multivariate analyses were performed to identify the factors that were predictive of response and prognostic of progression-free survival (PFS) and overall survival (OS). RESULTS: The overall and complete response rates to ABVD in patients with HIV-associated HL were 91% and 83%, respectively. After a median follow-up of 5 years, the 5-year PFS and OS rates were 69% and 78%, respectively. In multivariate analyses, there was a trend toward an IPS score >3 as an adverse factor for PFS (hazard ratio [HR], 1.49; P=.15) and OS (HR, 1.84; P=.06). A cluster of differentiation 4 (CD4)-positive (T-helper) cell count <200 cells/μL was associated independently with both PFS (HR, 2.60; P=.002) and OS (HR, 2.04; P=.04). The CD4-positive cell count was associated with an increased incidence of death from other causes (HR, 2.64; P=.04) but not with death from HL-related causes (HR, 1.55; P=.32). CONCLUSIONS: The current results indicate excellent response and survival rates in patients with HIV-associated, advanced-stage, classical HL who receive ABVD and combination antiretroviral therapy as well as the prognostic value of the CD4-positive cell count at the time of lymphoma diagnosis for PFS and OS.

Original languageEnglish (US)
Pages (from-to)423-431
Number of pages9
JournalCancer
Volume121
Issue number3
DOIs
StatePublished - Feb 1 2015

Fingerprint

Dacarbazine
Vinblastine
Bleomycin
Hodgkin Disease
Doxorubicin
Retrospective Studies
Disease-Free Survival
HIV
Survival
Cell Count
Therapeutics
Multivariate Analysis
Survival Rate
Virus Diseases
Cause of Death
Lymphoma
Incidence

Keywords

  • And dacarbazine
  • Antiretroviral therapy
  • Bleomycin
  • CD4 count
  • Doxorubicin
  • Hodgkin lymphoma
  • Human immunodeficiency virus
  • Vinblastine

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{5339f6d0827646a4949f5c487ca3079e,
title = "Prognostic factors for advanced-stage human immunodeficiency virus-associated classical Hodgkin lymphoma treated with doxorubicin, bleomycin, vinblastine, and dacarbazine plus combined antiretroviral therapy: A multi-institutional retrospective study",
abstract = "BACKGROUND: The treatment and outcomes of patients with human immunodeficiency virus (HIV)-associated Hodgkin lymphoma (HL) continue to evolve. The International Prognostic Score (IPS) is used to predict the survival of patients with advanced-stage HL, but it has not been validated in patients with HIV infection. METHODS: This was a multi-institutional, retrospective study of 229 patients with HIV-associated, advanced-stage, classical HL who received doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus combination antiretroviral therapy. Their clinical characteristics were presented descriptively, and multivariate analyses were performed to identify the factors that were predictive of response and prognostic of progression-free survival (PFS) and overall survival (OS). RESULTS: The overall and complete response rates to ABVD in patients with HIV-associated HL were 91{\%} and 83{\%}, respectively. After a median follow-up of 5 years, the 5-year PFS and OS rates were 69{\%} and 78{\%}, respectively. In multivariate analyses, there was a trend toward an IPS score >3 as an adverse factor for PFS (hazard ratio [HR], 1.49; P=.15) and OS (HR, 1.84; P=.06). A cluster of differentiation 4 (CD4)-positive (T-helper) cell count <200 cells/μL was associated independently with both PFS (HR, 2.60; P=.002) and OS (HR, 2.04; P=.04). The CD4-positive cell count was associated with an increased incidence of death from other causes (HR, 2.64; P=.04) but not with death from HL-related causes (HR, 1.55; P=.32). CONCLUSIONS: The current results indicate excellent response and survival rates in patients with HIV-associated, advanced-stage, classical HL who receive ABVD and combination antiretroviral therapy as well as the prognostic value of the CD4-positive cell count at the time of lymphoma diagnosis for PFS and OS.",
keywords = "And dacarbazine, Antiretroviral therapy, Bleomycin, CD4 count, Doxorubicin, Hodgkin lymphoma, Human immunodeficiency virus, Vinblastine",
author = "{HIV-Associated Hodgkin Lymphoma in the cART Era Study Group} and Castillo, {Jorge J.} and Mark Bower and J{\'e}r{\'e}my Br{\"u}hlmann and Urban Novak and Hansjakob Furrer and Tanaka, {Paula Y.} and Caroline Besson and Silvia Montoto and Kate Cwynarski and Abramson, {Jeremy S.} and Samir Dalia and Michele Bibas and Connors, {Joseph M.} and Michael Furman and Nguyen, {Minh Ly} and Cooley, {Timothy P.} and Beltran, {Brady E.} and Collins, {Jaime A.} and Vose, {Julie Marie} and Blanca Xicoy and Ribera, {Josep Maria}",
year = "2015",
month = "2",
day = "1",
doi = "10.1002/cncr.29066",
language = "English (US)",
volume = "121",
pages = "423--431",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "3",

}

TY - JOUR

T1 - Prognostic factors for advanced-stage human immunodeficiency virus-associated classical Hodgkin lymphoma treated with doxorubicin, bleomycin, vinblastine, and dacarbazine plus combined antiretroviral therapy

T2 - A multi-institutional retrospective study

AU - HIV-Associated Hodgkin Lymphoma in the cART Era Study Group

AU - Castillo, Jorge J.

AU - Bower, Mark

AU - Brühlmann, Jérémy

AU - Novak, Urban

AU - Furrer, Hansjakob

AU - Tanaka, Paula Y.

AU - Besson, Caroline

AU - Montoto, Silvia

AU - Cwynarski, Kate

AU - Abramson, Jeremy S.

AU - Dalia, Samir

AU - Bibas, Michele

AU - Connors, Joseph M.

AU - Furman, Michael

AU - Nguyen, Minh Ly

AU - Cooley, Timothy P.

AU - Beltran, Brady E.

AU - Collins, Jaime A.

AU - Vose, Julie Marie

AU - Xicoy, Blanca

AU - Ribera, Josep Maria

PY - 2015/2/1

Y1 - 2015/2/1

N2 - BACKGROUND: The treatment and outcomes of patients with human immunodeficiency virus (HIV)-associated Hodgkin lymphoma (HL) continue to evolve. The International Prognostic Score (IPS) is used to predict the survival of patients with advanced-stage HL, but it has not been validated in patients with HIV infection. METHODS: This was a multi-institutional, retrospective study of 229 patients with HIV-associated, advanced-stage, classical HL who received doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus combination antiretroviral therapy. Their clinical characteristics were presented descriptively, and multivariate analyses were performed to identify the factors that were predictive of response and prognostic of progression-free survival (PFS) and overall survival (OS). RESULTS: The overall and complete response rates to ABVD in patients with HIV-associated HL were 91% and 83%, respectively. After a median follow-up of 5 years, the 5-year PFS and OS rates were 69% and 78%, respectively. In multivariate analyses, there was a trend toward an IPS score >3 as an adverse factor for PFS (hazard ratio [HR], 1.49; P=.15) and OS (HR, 1.84; P=.06). A cluster of differentiation 4 (CD4)-positive (T-helper) cell count <200 cells/μL was associated independently with both PFS (HR, 2.60; P=.002) and OS (HR, 2.04; P=.04). The CD4-positive cell count was associated with an increased incidence of death from other causes (HR, 2.64; P=.04) but not with death from HL-related causes (HR, 1.55; P=.32). CONCLUSIONS: The current results indicate excellent response and survival rates in patients with HIV-associated, advanced-stage, classical HL who receive ABVD and combination antiretroviral therapy as well as the prognostic value of the CD4-positive cell count at the time of lymphoma diagnosis for PFS and OS.

AB - BACKGROUND: The treatment and outcomes of patients with human immunodeficiency virus (HIV)-associated Hodgkin lymphoma (HL) continue to evolve. The International Prognostic Score (IPS) is used to predict the survival of patients with advanced-stage HL, but it has not been validated in patients with HIV infection. METHODS: This was a multi-institutional, retrospective study of 229 patients with HIV-associated, advanced-stage, classical HL who received doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus combination antiretroviral therapy. Their clinical characteristics were presented descriptively, and multivariate analyses were performed to identify the factors that were predictive of response and prognostic of progression-free survival (PFS) and overall survival (OS). RESULTS: The overall and complete response rates to ABVD in patients with HIV-associated HL were 91% and 83%, respectively. After a median follow-up of 5 years, the 5-year PFS and OS rates were 69% and 78%, respectively. In multivariate analyses, there was a trend toward an IPS score >3 as an adverse factor for PFS (hazard ratio [HR], 1.49; P=.15) and OS (HR, 1.84; P=.06). A cluster of differentiation 4 (CD4)-positive (T-helper) cell count <200 cells/μL was associated independently with both PFS (HR, 2.60; P=.002) and OS (HR, 2.04; P=.04). The CD4-positive cell count was associated with an increased incidence of death from other causes (HR, 2.64; P=.04) but not with death from HL-related causes (HR, 1.55; P=.32). CONCLUSIONS: The current results indicate excellent response and survival rates in patients with HIV-associated, advanced-stage, classical HL who receive ABVD and combination antiretroviral therapy as well as the prognostic value of the CD4-positive cell count at the time of lymphoma diagnosis for PFS and OS.

KW - And dacarbazine

KW - Antiretroviral therapy

KW - Bleomycin

KW - CD4 count

KW - Doxorubicin

KW - Hodgkin lymphoma

KW - Human immunodeficiency virus

KW - Vinblastine

UR - http://www.scopus.com/inward/record.url?scp=84921523294&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84921523294&partnerID=8YFLogxK

U2 - 10.1002/cncr.29066

DO - 10.1002/cncr.29066

M3 - Article

C2 - 25251326

AN - SCOPUS:84921523294

VL - 121

SP - 423

EP - 431

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 3

ER -